An autopsy case of primary hepatoma associated with an oral contraceptive

Primary hepatoma was found in a 38-year-old female who had been using an oral contraceptive for 28 months. Histologically the hepatoma was a well-differentiated hepatocellular carcinoma. Alpha-fetoprotein was not increased and tests for HBS antigen was negative. Carcinoembryonic antigen was elevated remarkably before death. The findings of hepatic arteriography and peritoneoscopy suggested metastatic tumors of the liver rather than primary hepatoma. During the course of the disease, phlebothrombosis occurred and spread widely in the lower left limb. The observation of erythrocytosis indicated the presence of a tumor producing erythropoietin or an erythropoietin-like substance.