Hepatic adenoma associated with oral contraceptive use: an unusual clinical presentation

H. F. Sears, G. Smith and R. D. Powell

A young woman who had taken contraceptive steroids for many years had the acute onset of abdominal pain because of central necrosis and hemorrhage into a hepatic adenoma. She had multiple lesions confined to one lobe of the liver. Persistent pyrexia and leukocytosis were also prominent clinical findings. She has had no evidence of recurrence of this problem during the seven years following right hepatic lobectomy. A review of the anabolic and contraceptive steroid-associated hepatic neoplasms is presented with comments directed toward the recognition of the critical clinical sequelae that can befall the patient with hepatic adenoma. Although all the patients in the steroid-treated group have tumors with benign and striking histologic similarity, microscopic evidence of malignant invasion of surrounding tissue is occassionally noted.