Testosterone-receptor positive hepatocellular carcinoma in a 29-year old bodybuilder with a history of anabolic androgenic steroid abuse: a case report

Abstract

BackgroundContinuous use of anabolic androgenic steroid in high-doses is associated with substantial health risks, including hepatocellular adenoma. Malignant transformation from hepatocellular adenoma to hepatocellular carcinoma after anabolic androgenic steroid abuse has been rarely reported. The morphological distinction of adenoma from well-differentiated hepatocellular carcinoma is challenging and requires elaborated imaging techniques and histology.Case presentationWe report about a 29-year old male professional bodybuilder who presented with mid-epigastric pain at the emergency unit. Ultrasound showed a severe hepatomegaly with multiple lesions. Contrast-enhanced ultrasound revealed a heterogeneous pattern with signs of hepatocellular carcinoma. CT scan of the abdomen confirmed multiple hypervascular lesions and central areas of necrosis without contrast enhancement. Subsequent diagnostics included fine needle aspiration (FNA) of suspicious lesions and mini-laparoscopy to establish the diagnosis of a β-catenin and testosterone-receptor positive hepatocellular carcinoma embedded in multiple adenomas. The patient was subsequently treated by liver transplantation and remains tumor-free 27 month after surgery.ConclusionHepatocellular carcinoma occurring in association with anabolic androgenic steroid abuse should sensitize physicians and especially professional bodybuilders for the harmful use of high doses of steroids.

Nandrolone induces a stem cell-like phenotype in human hepatocarcinoma-derived cell line inhibiting mitochondrial respiratory activity

“…The most relevant side-effect is hepatotoxicity since human liver expresses estrogen and androgen receptors and experimentally both androgens and estrogens have been implicated in stimulating hepatocyte proliferation, probably causing liver tumor 7,8 . Accordingly, several case reports highlight a link between AAS abuse and risk of developing the male-dominant hepatocellular carcinoma (HCC) [9][10][11][12] . Several studies supported the androgen/AR axis as a pivotal factor that contributes to gender difference in HCC etiology [13][14][15][16] .…”

Spectrophotometric and chromatographic strategies for exploring of the nanostructure pharmaceutical formulations which contains testosterone undecanoate

“…NPF like AAS can be divided into the following the groups: analogues obtained by esterification of the 17-β-hydroxyl group; analogues alkylated in 17-α position; analogues with the modified nuclei A, B and C 5 . Esterification of the 17-β-hydroxyl group with the carboxylic acids enables intramuscular administration of substance 6 . The most common 17-β esters are derived from the natural testosterone (i.e.…”

Anabolic steroid abuse and pancreatic insulinoma

“…It has been described that hepatocellular carcinoma raised from hepatic adenoma, which growth was associated with steroid intake [8]. Furthermore, another important issue is the coexistence of both malignant and benignbenign neoplasm [14], which entails the need of radical treatment even benign lesions.…”