Multiple hepatic adenomas and a hepatocellular carcinoma in a man on oral methyl testosterone for eleven years

Abstract

NDROGENIC, ESTROGENIC, AND PROCES-A togenic steroids all exert a metabolic and morphologic effect on the The female and male hormones have different but overlapping effects on the liver. Ingestion of estrogens and progesterones is associated with intrahepatic cholestasis, rise in serum transaminase, increased Bromsulphalein retention, and focal nodular hyperplasia. Ingestion of androgens is associated with cholestasis, peliosis hepatis, and hepatocellular carcinoma. The progesterones and 17-alkylated anabolic steroids affect mainly the smooth endoplasmic reticulum, whereas estrogens affect mainly protein synthesis in rough endoplasmic reticulum. All patients developing jaundice or hepatocellular carcinoma after treatment with anabolic steroids invariably have received compounds containing a methyl or ethyl group at the 17 position, e.g., oxymetholone or methyltestosterone. More From the .James Homer

Multiple hepatic adenomas caused by long-term administration of androgenic steroids for aplastic anemia in association with familial adenomatous polyposis

“…1 However, as clinical, radiological, and histological distinctions between HA and HCC are difficult, surgical resection, if possible, may be recommended for HA. 7 The largest tumor in our patient is large enough to represent a risk of malignant transformation, intratumoral bleeding, and rupture. In particular, the patient is a young woman with the possibility of pregnancy, which imposes a considerable risk.…”

“…1,2 There have been increasing reports of hepatic neoplasms in young women taking oral contraceptives, and, in some rare cases, in individuals of both sexes taking anabolic androgenic steroids. [3][4][5][6][7][8][9] Although most of these tumors are benign, early detection is important for avoiding the associated risks of life-threatening hemorrhage 5,8 and malignant degeneration. 7 We report a case of hepatic adenomas in a 20-year-old Japanese girl treated with anabolic androgens for aplastic anemia over a long term.…”

“…[3][4][5][6][7][8][9] Although most of these tumors are benign, early detection is important for avoiding the associated risks of life-threatening hemorrhage 5,8 and malignant degeneration. 7 We report a case of hepatic adenomas in a 20-year-old Japanese girl treated with anabolic androgens for aplastic anemia over a long term. This report may be helpful in identifying the population at risk of developing hepatic neoplasms from sex hormones.…”

Management of liver adenomatosis: Results with a conservative surgical approach

“…1,2 HAs are usually solitary lesions that can reach several centimeters in size, causing abdominal pain and hemorrhage either intrahepatically or intraperitoneally.…”

Testosterone replacement therapy for male hypogonadism: Part III. Pharmacologic and clinical profiles, monitoring, safety issues, and potential future agents

“…MeT). [42][43][44][45] Further evidence for direct androgenic effects of oral T (TU; testosterone undecanoate) on the liver include significant, persistent suppression of sex hormone binding globulin (SHBG). 46 Although the intact ester of TU is absorbed by the lymphatics, most of the oral dose is hydrolyzed in the wall of the gut, and metabolites are absorbed into the portal circulation.…”