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  • Title: Hepatocellular adenoma and oral contraceptives.
    Author: Ammentorp PA, Carson RP.
    Journal: Ohio State Med J; 1976 May; 72(5):283-6. PubMed ID: 1272546.
    Abstract:
    A report from a medium-sized community hospital of 4 additional cases of hepatocellular adenoma is presented. Of these, 3 were pedunculated tumors. A 29-year-old woman, gravida 7, had been taking Enovid-E for 8 years. After 3 attacks of epigastric pain a mass was detected in her right upper abdomen. Surgical exploration revealed the mass pedunculated from the right hepatic lobe. The mass was excised. 3 years later a liver scan was normal. The histological appearance of the tissue resembled mature hepatic architecture without protal areas or bile ducts. A 34-year-old woman, gravida 4, para 2, had been taking Enovid-E for 6 years. She previously had had a partial thyroidectomy for carcinoma of the thyroid and later radical neck dissection for metastatic thyroid carcinoma. A mass was detected in the right abdomen. At operation, a pedunculated mass was found attached to the right hepatic lobe with 2 smaller nodules. All lesions were excised. The microscopic picture was similar to that of the other patient. A 24-year-old woman, gravida 4, para 3, had been taking Oracon for 1 year. Upper abdominal pain, vomiting, and diarrhea were complained of. An upper abdominal mass was present. At operation, a 9 cm mass was excised. The histology was the same as in the previous cases. A 28-year-old woman, gravida 2, para 1, had been taking Ovulen for 5 years. An abdominal mass was present. Surgical exploration revealed a nodular mass pedunculated from the left lobe of the liver. The mass was excised. Histological appearance was similar to the other 3 tumors. Of 42 other reported cases of similar tumors, the mean age was 27.3 years. About 40% had been admitted as emergency cases with hemoperitoneum. Almost 20% had complained of upper abdominal pain. A palpable mass was usually present. Multiple nodules were found in 13% of cases. For nonemergency cases, selective hepatic angiography has been a reliable method of diagnosis. The treatment has been resection of the tumor when feasible. However, regression of tumors has occurred when exogenous hormone influence ceased. The outcome has been fatal in 8 cases. The low incidence of this tumor is not considered sufficient cause to justify discontinuing use of oral contraceptives.
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