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World J Surg. 1983 Mar;7(2):247-52.

Abnormal sex-steroid milieu in young adults with hepatocellular carcinoma.



Analysis of 7 patients 20-30 years of age treated for hepatic cell carcinoma during the past 15 years at Massachusetts General Hospital indicated that 5 had an androgenous or exogenous disturbance of gonadal function. The 2 men in this series were taking methyltestosterone. Of the women, 2 had been taking oral contraceptives (OCs) for long durations, 1 had Stein-Leventhal syndrome, and 1 was infertile for 18 months. 3 of the 4 women with altered reproductive function had fibrolamellar carcinomas. These cases suggest that abnormalties of hypophyseal-gonadal endocrine metabolism can predispose to the development of hepatic cell carcinoma. Cessation of methyltestosterone or OC use and major hepatectomy apparently cured 3 of these patients. Although the data are consistent with a role for sex steroids in some cases of hepatic carcinogenesis, a case-control study would be needed to eliminate chance occurrence of fibrolamellar-variant cancer in the age group most likely to be using OCs. It is likely that hepatic carcinogenesis is a complex process involving genetic susceptibility, drug potency, regenerative urges, and the cooperation of promoters and co-carcinogens.

[Indexed for MEDLINE]

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