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Acta Chir Scand. 1982;148(1):89-91.

Benign liver tumors and oral contraceptives.



The article presents the case of a healthy 30 year old patient, parity 2, who had been on oral contraception (OC) for 15 years. She sought medical advice for an egg-sized, mobile abdominal mass; when the patient noted that the mass had considerably increased in size laparotomy was performed. The operation revealed a slightly nodular, pedunculated tumor the size of an orange; it was classified as a well differentiated benign hepatic adenoma. About 2/3 of benign liver neoplasms thought to be the results of estrogen/progestogen treatment can be defined as true hepatic cell adenomas; the remainder are known as focal nodular hyperplasia. The lesions are probably the reaction of the normal hepatocyte to the metabolic changes induced by chronic administration of estrogen or progesterone; they are usually aggravated by smoking. In the cases reported in the published literature the time of exposure varies from 6 months to 12 years; the risk is greater with longer exposure, age over 30, "older" high potency OC containing mestranol, and smoking. A detailed patient's history is essential for correct diagnosis, together with manual examination; liver scans, ultrasound examination and arteriography are very useful. Treatment consists in discontinuing OC. Hemorrhage from the tumor carries a mortality of 6-8%. Surgery should be performed if regression of the tumor does not occur within a few months after withdrawal of OC. About 10% of these benign tumors undergo malignant changes.

[Indexed for MEDLINE]

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