Hepatic Cell Adenomas, Spontaneous Liver Rupture, and Oral Contraceptives

Liver cell adenoma showing sequential alteration of radiological findings suggestive of well-differentiated hepatocellular carcinoma

“…It is reported that hemorrhage is found in about one half of LCAs and can result in death [9,16,28] . Malignant transformation of LCA is considered to be rare.…”

Oral Contraceptives and Liver Tumours

“…There is a tendency in present circumstances for cases to be reported where the patient has been on the pill, and not otherwise unless there are clinical or pathological features of exceptional interest. Furthermore, some cases have almost certainly been reported more than once (Baum et al 1973, Ameriks et al 1975) and this distorts the figures. Both hepatic adenoma and focal nodular hyperplasia are well known to be commoner in women than in men, and to be commonest in women during reproductive life.…”

“…A further 3 cases were described from Canada (Fisher et al 1975, Shojania & Hogg 1975 and another example of focal nodular hyperplasia in a woman who had been on the pill appeared from Sweden (Zurbriggen & Tylen 1975). Baum (1975) referred to 6 cases additional to her original 7, but it is not clear that these are different from the patients reported by Ameriks et al (1975). In August, Christopherson et al (1975) added a further 7 cases of focal nodular hyperplasia and one hepatic adenoma in women who had taken oral contraceptives.…”

“…Ameriks et al (1975) (1973). They first read their paper at a surgical meeting, and 2 more similar cases were recalled by members of the audience in the discussion.…”

Liver Resection for Hepatic Adenoma

“…In 1973, Baum et al 8 suggested that the development of benign liver tumors might be caused by the use of oral contraceptive pills and since then, there have been many reports concerning a possible relationship between oral contraceptives and hepatic adenoma, [9][10][11][12][13][14][15][16][17][18][19][20][21][22] focal nodular hyperplasia, 21,[23][24][25] and malignant hepatoma. 26 On the other hand, Guzman et al 13 have pointed out that the association described by Baum and co-workers is not found in all series of cases; in fact, only three of ten patients of Guzman et al having hepatic adenomas had taken oral contraceptives before the development of their tumors.…”