Hepatocellular adenomas associated with anabolic androgenic steroid abuse in bodybuilders: a report of two cases and a review of the literature.

Br J Sports Med. 2005 May;39(5):e27.

Hepatocellular adenomas associated with anabolic androgenic steroid abuse in
bodybuilders: a report of two cases and a review of the literature.

Socas L, Zumbado M, Pérez-Luzardo O, Ramos A, Pérez C, Hernández JR, Boada LD.

Department of Radiology, Cajal Clinical Centre, Las Palmas de Gran Canaria,
Canary Islands, Spain.

Anabolic androgenic steroids (AAS) are used illicitly at high doses by
bodybuilders. The misuse of these drugs is associated with serious adverse
effects to the liver, including cellular adenomas and adenocarcinomas. We report
two very different cases of adult male bodybuilders who developed hepatocellular
adenomas following AAS abuse. The first patient was asymptomatic but had two
large liver lesions which were detected by ultrasound studies after routine
medical examination. The second patient was admitted to our hospital with acute
renal failure and ultrasound (US) studies showed mild hepatomegaly with several
very close hyperecogenic nodules in liver, concordant with adenomas at first
diagnosis. In both cases the patients have evolved favourably and the tumours
have shown a tendency to regress after the withdrawal of AAS. The cases presented
here are rare but may well be suggestive of the natural course of AAS induced
hepatocellular adenomas. In conclusion, sportsmen taking AAS should be considered
as a group at risk of developing hepatic sex hormone related tumours.
Consequently, they should be carefully and periodically monitored with US
studies. In any case, despite the size of the tumours detected in these two
cases, the possibility of spontaneous tumour regression must also be taken in
account.