Hepatocellular carcinoma associated with anabolic steroid therapy: Report of a case and review of the Japanese literature

Kosaka, Atsushi; Takahashi, Hiroaki; Yajima, Yukihiro; Tanaka, Minoru; Okamura, Kazunori; Mizumoto, Ryuji; Katsuta, Koji

doi:10.1007/bf02355039

Cited by 32 publications

(19 citation statements)

References 18 publications

(1 reference statement)

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“…a-Fetoprotein (AFP) is a serum marker which is often elevated in HCC [80]. AFP was increased in 0/10 FA, 3/15 non-FA AA, and 1/12 non-AA in whom it was measured [14,33,58], as well as one non-AA case with cholangiohepatocarcinoma [67]. Additional risk factors for the development of cirrhosis and subsequent HCC, such as transfusion histories and titers of hepatitis B and C and other viruses, were described too infrequently for analysis.…”

Section: Resultsmentioning

confidence: 99%

Androgens and liver tumors: Fanconi's anemia and non‐Fanconi's conditions

2004

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The association between anabolic androgenic steroids and liver tumors was first noted in patients with Fanconi's anemia (FA). The hypotheses which led to this review were as follows: (1) androgen-treated individuals who do not have FA are also at risk of liver tumors; (2) parenteral as well as oral androgens may be responsible for liver tumors; (3) FA patients develop liver tumors after smaller and briefer androgen exposure than non-FA individuals; (4) the risk of hepatic neoplasms may depend on the specific androgen. Medline and Web of Science were searched for all cases of liver tumors associated with androgens. Information from individual cases was entered into a spreadsheet and descriptive statistical analyses were performed. Thirty-six FA cases and 97 non-FA cases with both nonhematologic disorders and acquired aplastic anemia (non-FA AA) were identified. The most common androgens were oxymetholone, methyltestosterone, and danazol. Hepatocellular carcinomas (HCC) were more often associated with oxymetholone and methyltestosterone, while adenomas were associated with danazol. Tumors were reported in six patients who received only parenteral and not oral androgens. FA patients were younger than non-FA patients when androgen use was initiated, and the FA patients developed tumors at younger ages. Non-AA patients were treated with androgens for longer periods of time, compared with FA and non-FA AA patients. All patients on anabolic androgenic steroids are at risk of liver tumors, regardless of underlying diagnosis. The magnitude of the risk cannot be determined from currently available data, because the number of patients receiving androgens is unknown. Am.

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Section: Resultsmentioning

confidence: 99%

Androgens and liver tumors: Fanconi's anemia and non‐Fanconi's conditions

2004

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“…In cases of aplastic anemia, including patients with FA, long-term treatment with anabolic steroids and replacement therapy with blood components is commonly implemented. However, this approach requires extreme caution because of the association of anabolic steroid hormone therapy with iron deposition and hepatocarcinogenesis [ 17 , 18 ]. The patient in this report presented with iron deposition resulting from transfusion dependency and long-term treatment with anabolic steroid hormones and immunosuppressants.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Hepatocellular Carcinoma Complicated by Fanconi Anemia

Takahashi

Suzuki

Yokoyama

et al. 2017

Case Rep Gastroenterol

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A 42-year-old woman with liver tumors was referred to our hospital. Her condition was complicated by Fanconi anemia, and she had undergone total laryngectomy 8 years ago. On admission, contrast-enhanced computed tomography revealed hypervascular tumors in the right hepatic lobe. Ultrasound-guided tumor biopsy revealed that the tumor comprised moderately differentiated hepatocellular carcinoma. Although the patient exhibited preserved liver function (Child-Pugh A), complete blood count revealed severe pancytopenia. Eventually, the tumor was successfully treated by transcatheter arterial embolization (TAE). Both platelet transfusion and systemic administration of antibiotics were performed. She was discharged 35 days after TAE.

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“…Oxymetholone has been reported to be carcinogenic in aplastic anemias, leading to peliosis hepatis and formation of hepatic tumors [11,[16][17][18]. In one study, Oxymetholone therapy has been associated with cerebral venous thrombosis and subdural hematoma [19].…”

Section: Discussionmentioning

confidence: 99%

Effect of Oxymetholone on SCE frequency in human lymphocyte chromosomes in vitro

Ahmad

Shadab

Azfer

2003

Teratog. Carcinog. Mutagen.

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Genotoxicity evaluation of a commonly used synthetic androgen, Oxymetholone, was carried out in human peripheral blood lymphocytes in vitro. Sister chromatid exchange (SCE) was used as genetic end point. The concentrations of the drug were determined after observing its effects on the mitotic index. A wide range of concentrations, i.e., 25, 50, and 100 micro g/ml of the drug, were used to determine the genotoxic effects in the absence as well as in the presence of rat liver microsomal activation system (S9 mix). The drug did not induce any significant increase in the SCE frequency at any of the concentrations either in the presence or in the absence of S9 mix. The maximum value of SCE was observed in the absence of S9 mix at 100 microg/ml concentration (i.e., 1.38+/-0.080/cell), which was not significant statistically. Moreover, the drug was not effective in increasing the SCE frequency even in the presence of S9 mix. The maximum value of SCE (i.e., 1.78+/-0.103/cell) was observed at 50 microg/ml of concentration in the presence of S9 mix. A dose relationship was also not observed. It was concluded that Oxymetholone does not affect the genetic material in human lymphocytes at a wide range of concentrations in the SCE assay.

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Hepatocellular carcinoma associated with anabolic steroid therapy: Report of a case and review of the Japanese literature

Cited by 32 publications

References 18 publications

Androgens and liver tumors: Fanconi's anemia and non‐Fanconi's conditions

Androgens and liver tumors: Fanconi's anemia and non‐Fanconi's conditions

Successful Treatment of Hepatocellular Carcinoma Complicated by Fanconi Anemia

Effect of Oxymetholone on SCE frequency in human lymphocyte chromosomes in vitro

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