Benign hepatic lesions and orally administered contraceptives

Fechner, Robert E.

doi:10.1016/s0046-8177(77)80022-1

Cited by 77 publications

(7 citation statements)

References 56 publications

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“…In addition, estrogen was found to promote HCC in rats [15-19]. Some reports also showed that oral contraceptives (OCPs) led to a higher incidence of liver diseases such as focal nodular hyperplasia, liver haemangioma and hepatocellular adenoma, which are considered premalignant stages of HCC [20,21]. However, a systematic review concluded that no benefits could be gained by anti-estrogen in regards to overall survival and life quality [22].…”

Section: Introductionmentioning

confidence: 99%

Role of estrogen in hepatocellular carcinoma: is inflammation the key?

et al. 2014

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Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide and accounts for the third-leading cause of cancer-related deaths. Over the past decades, advances have been made in the field of surgery, but effective treatment of HCC is lacking. Due to a marked male predominance in morbidity and mortality in HCC patients, it has long been considered that sex hormones play a role in HCC development. Recently estrogen has been proven to exert protective effects against HCC through IL-6 restrictions, STAT3 inactivation and tumour-associated macrophage inhibition. While IL-6-dependent STAT3 activation is considered a key event in inflammation-induced liver cancer, the anti-inflammation effect of estrogen is well documented. The roles of the estrogen receptor and aromatase and interactions between microRNAs and estrogen in HCC have been investigated. In this review, we present a novel model to elucidate the mechanism of estrogen-mediated inhibition of HCC development through an anti-inflammation effect and provide new insights into the roles of estrogen in liver disease.

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Section: Introductionmentioning

confidence: 99%

Role of estrogen in hepatocellular carcinoma: is inflammation the key?

et al. 2014

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“…The association between the OCP and benign hepatocellular adenoma has been well established for several decades,6 although both gross and histological features of this patient’s lesion were inconsistent with HCC evolved from hepatocellular adenoma. Evidence for an association between HCC and the OCP remains inconclusive 7.…”

Section: Discussionmentioning

confidence: 81%

Exophytic cystic liver lesion: an unusual presentation of a hepatocellular carcinoma in a young female

Gardiner¹,

Nasralla

Fryer

et al. 2017

BMJ Case Reports

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Hepatocellular carcinoma (HCC) is one of the most common malignant primary liver tumours. However, primary hepatic carcinomas are rare in young adults, accounting for approximately 1% of tumours in people below the age of 20. Hepatitis B virus (HBV) and hepatitis C virus (HCV) infection are the two most important aetiological agents of HCC. The average age at onset of HBV-related HCC (~50 years old) is 10 years younger than that of HCV-related HCC (61-64 years). Evidence for an association between the oral contraceptive pill (OCP) and development of HCC remains inconclusive. Here, we describe a case of a 28-year-old woman with normal background liver, who presented with a large palpable abdominal mass due to a bilobar, exophytic, cystic lesion arising from the right lobe of the liver, later diagnosed as HCC on histological analysis. We highlight the need for considering HCC even in the unusual setting of a cystic, exophytic lesion.

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“…Studies on liver biopsies reported different types of liver pathological processes in OC users (1,2). Liver adenoma was the first tumor to be associated with the use of OCs ( 3 ) , but other liver tumors or tumor-like lesions, such as nodular hyperplasia and peliosis hepatis, may be associated (4)(5)(6). Development of liver carcinoma in OC users was also suggested (7,8).…”

Section: Discussionmentioning

confidence: 99%

“…Long-term use of oral contraceptives (OCs) is associated with the development of various types of hepatic lesions (1)(2)(3)(4)(5)(6)(7)(8). The assumption of most authors is that estrogen, by inducing liver enzymes and functions, contributes to the formation of tumors or tumor-like lesions.…”

mentioning

confidence: 99%

Regression of hepatic tumors during transdermal estradiol replacement therapy

Gdansky

Beller

Neuman

et al. 1995

Acta Obstet Gynecol Scand

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A 39 year-old patient with long-standing diagnosis of pelvic endometriosis had been treated for over twenty years with oral contraceptives (OCs). A year prior to admission to the gynecological ward, an ultrasonographic examination revealed three hepatic lesions, which were not reported in previous liver sonography. These lesions progressed during OC use, over the next six months. Liver function tests were normal. Liver scan, CT and ultrasound imaging techniques supported the diagnosis of solid hepatic tumors. These lesions developed concomitantly to long-term use of OCs, therefore discontinuation of therapy was mandatory. Six months later, the patient was hospitalized due to pelvic pain. She underwent total abdominal hysterectomy and left salpingo-oophorectomy (the right adnexa had been removed years before). Due to the patient's young age, hormone replacement therapy was indicated. The preferred preparation was transdermal estradiol due to the fact that systemic absorption has no hepatic first-pass effect and therefore exerts minimal influence on liver enzymes and functions. Serial ultrasonographic examinations, performed while under treatment with transdermal estradiol, showed complete regression of the hepatic lesions over a period of two years. Our report demonstrates regression of multifocal hepatic tumors despite transdermal estradiol replacement therapy.

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Benign hepatic lesions and orally administered contraceptives

Cited by 77 publications

References 56 publications

Role of estrogen in hepatocellular carcinoma: is inflammation the key?

Role of estrogen in hepatocellular carcinoma: is inflammation the key?

Exophytic cystic liver lesion: an unusual presentation of a hepatocellular carcinoma in a young female

Regression of hepatic tumors during transdermal estradiol replacement therapy

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