ROLE OF ORAL-CONTRACEPTIVES IN THE GROWTH OF A MULTILOBULAR ADENOMA ASSOCIATED WITH A HEPATOCELLULAR-CARCINOMA IN A YOUNG WOMAN

Background: The occurrence of hepatocellular neoplasms is frequently r eported in young females. The role of oral contraceptives in the devel opment of these tumors is considered. Methods: A 14-cm tumor was diagn osed in a 24-year-old female who had been taking the contraceptive pil l for the last 3 years. Numerous blocks of this lesion were histologic ally and immunohistochemically analyzed. Some fragments of the lesion were snap-frozen in order to search for sex hormonal receptors and hep atitis B and C virus. Results: On histological examination, the tumor was found to be a hepatocellular, multilobular adenoma with small foci of hepatocellular carcinoma. Neither hepatitis B virus nor hepatitis C virus was found in serum or in the tumor. Nuclear estrogen receptors and progesterone receptors were detected by immunohistochemical analy sis in both the adenoma and the carcinoma, but only progesterone recep tors were detected by a radio-ligand binding assay in the tumor. Concl usion: This finding suggests that the contraceptive pill may stimulate the growth of hepatocellular, multilobular adenomas through the bindi ng of hormonal compounds to their specific receptors within tumoral ce lls.