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Androgen-induced hepatoma.

G C Farrell, D E Joshua, R F Uren

    Lancet (London, England)
    |February 22, 1975
    PubMed
    Summary
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    Young men using androgenic-anabolic steroids developed liver tumors. Tumor regression occurred after steroid cessation, suggesting a link between these steroids and hepatocellular carcinoma. Medical use should be restricted to serious conditions.

    Area of Science:

    • Hepatology
    • Oncology
    • Endocrinology

    Background:

    • Androgenic-anabolic steroids (AAS) are synthetic derivatives of testosterone.
    • Their non-medical use is prevalent in certain athletic and bodybuilding communities.
    • Previous reports have suggested a potential link between AAS use and liver abnormalities, including tumors.

    Purpose of the Study:

    • To report and analyze cases of hepatocellular carcinoma (HCC) in young men with a history of AAS use.
    • To investigate the relationship between AAS and the development and progression of liver tumors.
    • To assess the efficacy of discontinuing AAS in tumor regression and recommend monitoring strategies.

    Main Methods:

    • Case series reporting on three young male patients diagnosed with HCC.

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  • Histopathological examination of tumor samples.
  • Longitudinal observation of tumor progression and response to treatment (cessation of AAS).
  • Evaluation of liver function tests and alpha-fetoprotein (AFP) levels.
  • Assessment of isotopic liver scanning for monitoring.

    • Main Results:

    • Three cases of HCC were observed in young men with documented AAS use.
    • Tumors showed histological similarities to previously reported AAS-associated liver tumors.
    • Slow tumor progression was noted in two patients over 4 and 7 years, with one developing bone metastases.
    • Tumor regression was observed in two patients after discontinuation of AAS.
    • Biochemical markers (liver function tests, AFP) were not effective screening tools for hepatoma in this cohort.

    Conclusions:

    • These cases provide further evidence linking exogenous androgenic-anabolic steroid use to the development of liver tumors, specifically hepatocellular carcinoma.
    • The findings support the recommendation to restrict the use of AAS to medically indicated serious conditions.
    • Regular isotopic liver scanning is advised for monitoring patients using AAS, as standard biochemical tests are insufficient for early hepatoma detection.