A case of hepatocellular adenoma associated with anabolic steroids therapy for aplastic anemia

Abstract

The patient, a 4 1/4-year-old girl, was diagnosed as aplastic anemia and treated for 2 1/3 years with androgenic anabolic steroids (Winstrol, Enarmon and Enarmon depot). She died of diabetic coma. At autopsy, a 2.0×2.0×1.5 cm sized tumor was found in the right lobe of the liver. This tumor was sharply demarcated from the surrounding tissue, but had no fibrous capsule. Histologically, it was divided irregularly with loose conective tissues and composed of mature hepatocytes, which were arranged in two-cell plates and partly in tubular structures. There was no histological evidence of viral hepatitis and cirrhosis. A diagnosis of hepatocellular adenoma was made and it was considered to be induced by androgenic anabolic steroids. In the past literatures, 16 cases of liver tumors due to androgenic anabolic steroids were reported. And recently there has been increasing number of reports concerning association between oral contraceptives and liver tumors. These kinds of steroids have similar chemical structure and the liver tumors induced by them have very similar histological pattern. However various terms were used for those lesions. Therefore, we reported the present case with some discussions.