"Alcoholic hepatitis" in a hepatic adenoma

Area of Science:

• Hepatology
• Gastroenterology
• Oncology

Background:

• Oral contraceptives and sulfonylureas are associated with hepatic adenoma development.
• Adult-onset diabetes mellitus requires long-term management, often with oral medications.

Observation:

• A 26-year-old woman presented with a hepatic adenoma after 10 years of oral contraceptive use and 5 years of tolazamide (sulfonylurea) for diabetes.
• The tumor exhibited typical hepatic adenoma characteristics clinically and grossly.
• Microscopic examination revealed steatonecrosis and Mallory bodies, resembling alcoholic hepatitis.

Findings:

• Transmission electron microscopy identified Mallory bodies as intermediate filament tangles.
• Immunohistochemistry showed Mallory bodies staining positive for cytokeratin, similar to alcoholic hyalin.
• The surrounding liver tissue was histologically normal.

Implications:

• This case highlights a unique histological presentation of hepatic adenoma.
• It suggests a potential link between specific medications and atypical tumor morphology.
• Further research may elucidate the mechanisms behind drug-induced histological changes in hepatic neoplasms.