Hepatic Tumors: Possible Relationship to Use of Oral Contraceptives

Klatskin, Gerald

doi:10.1016/s0016-5085(19)32205-x

Cited by 267 publications

(49 citation statements)

References 73 publications

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“…The clinical symptoms of HA include abdominal pain and distension due to the presence of a mass, but in many instances the tumor is asymptomatic and it is diagnosed incidentally [4]. The liver function tests are generally normal, but a slight elevation of serum transaminases or alkaline phosphatase may be observed.…”

Section: Discussionmentioning

confidence: 99%

“…A percutaneous liver biopsy is controversial because the histology is often non-diagnostic and the procedure carries the risk of acute hemorrhage [4,5,8,14]. Although HA is first detected by ultrasound in many cases, the sonographic features are usually non-specific and they may mimic other benign or malignant hepatic lesions.…”

Section: Discussionmentioning

confidence: 99%

“…There have been many reports about the relationship between oral contraceptives and HA, and this relationship was first described by Banum, et al [2]. However, the precise mechanism for this relationship has not yet been determined [3,4]. Besides oral contraceptives, there are other predisposing factors for HA such as anabolic steroids, diabetes mellitus, beta-thalassemia and glycogen storage disease type 1 [5-7].…”

Section: Introductionmentioning

confidence: 99%

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A Case of Hepatocellular Carcinoma Within Hepatocellular Adenoma in a Non-Cirrhotic Male

Kim

Nam

et al. 2009

Korean J Intern Med

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Hepatocellular adenoma (HA) is a benign hepatic lesion that predominantly occurs in young women. Most hepatocellular carcinomas (HCC) arise in a cirrhotic liver during the fifth or sixth decades. There have been several reported cases of HCC developing from HA in female patients. However, there are rare cases about HCC arising in HA in a non-cirrhotic male patient. We have recently encountered a 53-year-old man who had a liver mass in a non-cirrhotic liver, and the liver mass was compatible with HA on the pre-operative computed tomography. The mass was completely resected and the histopathology revealed a focus of HCC arising in HA. We report here on this case along with a brief review of the relevant literature.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Case of Hepatocellular Carcinoma Within Hepatocellular Adenoma in a Non-Cirrhotic Male

Kim

Nam

et al. 2009

Korean J Intern Med

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“…8 This series differs from other large series in that most patients were symptomatic from the focal nodular hyperplasia at presentation. In a 20 year review from the Mayo clinic only four of 41 adult patients were symptomatic.4 The others presented as incidental laparotomy findings (22) or necropsy findings (11) or were discovered at routine physical examination (four). In three large collected series only 53 (23%) of 229 patients with focal nodular hyperplasia were symptomatic at the time of diagnosis.23 5 One ofthe reasons why so many ofour patients were symptomatic at presentation may relate to the size of the lesions.…”

Section: Discussionmentioning

confidence: 99%

Focal nodular hyperplasia of the liver: results of treatment and options in management.

Pain

Gimson

Williams

et al. 1991

Gut

121

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Twenty two patients (19 females) with focal nodular hyperplasia were seen between 1973 and 1989. Five were children, and all the adults were aged under 42 years (median 33 years). Fourteen patients (64%) were symptomatic on presentation. Twelve of the 14 adult women had taken the oral contraceptive pill. Twelve patients, nine of whom were symptomatic, underwent hepatic resection shortly after presentation. There were no deaths or major complications, and all remain well on follow up. Four patients underwent either hepatic artery embolisation or ligation. After an interval of six to 10 years they were asymptomatic and only one has histological evidence of residual focal nodular hyperplasia. Of five patients initially treated conservatively, two were asymptomatic and have remained so for three and 13 years. One of the three symptomatic patients became symptom free after stopping the contraceptive pill. The management of focal nodular hyperplasia requires a flexible approach. Lesions which are asymptomatic can be observed with regular ultrasound and treated if they enlarge or become symptomatic. Symptomatic patients who present while taking the contraceptive pill can also have a trial of conservative treatment. Other symptomatic patients, including those who previously took the pill, are best treated by surgical resection, and, where this is not possible, by embolisation.

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“…Hepatocellular adenomas are usually solitary, but multiple adenomas are not uncommon [106,107] . They occur predominantly in women of child-bearing age, and their presence is strongly associated with the use of oral contraceptives [108,109] . Although adenomas can regress or completely disappear after withdrawal of oral contraceptives [110,111] , they may continue to enlarge despite discontinuation of the drug [113] .…”

Section: Hepatocellular Adenomamentioning

confidence: 99%

Distinguishing benign from malignant liver tumours

Heiken

2007

Cancer Imaging

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Liver masses are very common and most are benign. It is therefore important to avoid unnecessary interventions for benign lesions, while at the same time ensuring accurate diagnosis of hepatic malignancies. Many cancer patients, like the general population, have incidental benign liver lesions. In planning treatment for cancer patients, it is critical to avoid inappropriate treatment decisions based on misdiagnosis of a benign lesion as a metastasis or primary liver malignancy. This article describes the salient imaging features of the common benign liver masses and outlines a general approach to distinguishing between benign and malignant hepatic lesions.

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Hepatic Tumors: Possible Relationship to Use of Oral Contraceptives

Cited by 267 publications

References 73 publications

A Case of Hepatocellular Carcinoma Within Hepatocellular Adenoma in a Non-Cirrhotic Male

A Case of Hepatocellular Carcinoma Within Hepatocellular Adenoma in a Non-Cirrhotic Male

Focal nodular hyperplasia of the liver: results of treatment and options in management.

Distinguishing benign from malignant liver tumours

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