Multiple hepatic adenomas caused by long-term administration of androgenic steroids for aplastic anemia in association with familial adenomatous polyposis

J Gastroenterol. 2000;35(7):557-62.

Multiple hepatic adenomas caused by long-term administration of androgenic
steroids for aplastic anemia in association with familial adenomatous polyposis.

Nakao A, Sakagami K, Nakata Y, Komazawa K, Amimoto T, Nakashima K, Isozaki H,
Takakura N, Tanaka N.

Department of Surgery, Shobara Red Cross Hospital, Japan.

We report a rare case of hepatic adenomas (HA), in a 20-year-old Japanese girl
treated for 6 years with anabolic androgens for aplastic anemia. In a review of
the world literature using computer MEDLINE search, we found only 17 cases of
androgen-induced HA published between 1975 and 1998 in the English-language
literature. The patient was referred to us because of liver lesions detected
during a follow-up examination for familial adenomatous polyposis. After being
diagnosed with aplastic anemia at 14 years of age, she had been treated with
oxymetholone (30 mg/day) for 6 years. Laboratory evaluation revealed normal liver
function. Ultrasonography (US) and computed tomography (CT) demonstrated multiple
liver lesions. Histopathological examinations of biopsied specimens from the
liver tumor showed HA. After the patient was diagnosed with HA, oxymetholone was
tapered off. Patients taking androgenic-anabolic steroids should be carefully
monitored with US and CT and tumor markers should be measured. This report may be
helpful in identifying the population who is at risk of developing hepatic sex
hormone-related tumors.