Case Report: Hepatocellular adenoma due to long-term oral stanozolol administration

This article presents a case of a 15-year-old male with a 6-year history of aplastic anemia treated with long-term oral stanozolol to promote hematopoiesis. Throughout this period, he underwent regular outpatient follow-up assessments of blood and liver function parameters. While abnormal liver function was recorded on several occasions and treated with oral hepatoprotective drugs, no abdominal imaging test was conducted. On this occasion, the patient was admitted to hospital with abdominal pain. Abdominal imaging revealed a liver tumor of undetermined nature. A diagnosis of β-catenin-activated hepatocellular adenoma was subsequently confirmed via hepatic perforation biopsy. Considering the high bleeding risk, transcatheter hepatic artery embolization was performed as a preventative measure. Stanozolol was discontinued immediately after diagnosis and replaced with platelet-boosting therapy using romiplostim. A repeat abdominal CT scan performed 4 months after discontinuation of the drug showed a significant reduction in lesion size, which continued to be closely monitored. Hepatocellular adenoma is a rare clinical scenario. This case, supported by complete data and gold-standard pathologic diagnosis, provided valuable insights, suggesting that patients on long-term androgen therapy with aplastic anemia constituted a high-risk group for hepatocellular adenoma, and highlighted the need to optimize management strategies.