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Human liver tumors in relation to steroidal usage.

G H Barrows, W M Christopherson

    Environmental Health Perspectives
    |April 1, 1983
    PubMed
    Summary

    Steroid use is linked to liver tumors, primarily benign focal nodular hyperplasia and hepatocellular adenoma in young adults. Discontinuing steroids can lead to tumor regression, while continued use may cause recurrence.

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    Area of Science:

    • Hepatology
    • Endocrinology
    • Oncology

    Background:

    • Association between steroid use and liver neoplasia reported since 1973.
    • Over 250 cases of hepatic neoplasia examined, mostly in steroid-medicated patients.

    Purpose of the Study:

    • To examine the histology of hepatic neoplasia in patients using steroid medications.
    • To analyze the types of liver tumors, patient demographics, and clinical outcomes associated with steroid use.

    Main Methods:

    • Histological examination of over 250 referral cases of hepatic neoplasia.
    • Analysis of patient steroid exposure history, including duration and type of agent.
    • Clinical data review for hemorrhage, recurrence, and regression.

    Main Results:

    Keywords:
    Age DistributionBiologyCancerContraceptionContraceptive AgentsContraceptive Agents, FemaleContraceptive Methods--side effectsData CollectionDiseasesFamily PlanningHistologyLiver NeoplasmsMortalityNeoplasmsOral Contraceptives--side effectsPainPregnancyPuerperiumReproductive Control AgentsResearch Methodology

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    • Majority of tumors were benign: focal nodular hyperplasia (55%) and hepatocellular adenoma (39%).
    • 83% of patients had significant steroid exposure (average 71-79 months).
    • Hemorrhage occurred in 31% of hepatocellular adenoma and 9% of focal nodular hyperplasia cases. Tumor recurrence observed with continued steroid use; regression with discontinuation.

    Conclusions:

    • Steroid medications are associated with benign liver tumors, predominantly focal nodular hyperplasia and hepatocellular adenoma, in young adults.
    • Hormonal therapy, particularly with mestranol, is implicated.
    • Vascular changes in tumors may relate to steroid administration; rare malignant hepatocellular carcinomas also observed.