Liver tumours associated with hormonal administration

Abstract

A sudden increase in the incidence of benign tumours of the liver has been linked with administration of hormones —oestrogen and progestagen administration with benign hepatic tumours and androgens with malignant tumours with or without peliosis hepatis. Two patients who had been on oral contraceptives for 4 yr and 5 yr respectively, were found to have masses diagnosed as focal nodular hyperplasia, one of them being almost 10 cm across. Four other cases of focal nodular hyperplasia, two of them in males and one in a young teenager, are also recorded; the last named was a large nodule about 18 cm across and pedunculated. Excepting for this last the nodules were all asymptomatic. Nodules in the liver may be hyperplastic, neoplastic or regenerative. Focal nodular hyperplasia is classed as a hyperplastic condition but the differentiation from the so-called benign adenoma is difficult and these two lesions may be one and the same. The histological features of these various cases are discussed with reference to this classification. A general discussion is included in which the association of oral contraceptives or androgens with liver tumours will be touched on with reference to their pathogenesis and histopathology with illustrative slides. As benign tumours of the liver are extremely rare it is thought to be worthwhile recording these 8 instances, most of them within a period of 4 yr and only two of them distinctly associated with oral contraceptive therapy. A search of recent literature up to the end of 1977 reveals that there have been no cases of focal nodular hyperplasia associated with oral contraceptive therapy reported from this part of the world.