Asymptomatic liver cell adenomas. Another case of resolution after discontinuation of oral contraceptive use

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Abstract
Christopherson et al reported 1 case of focal nodular hyperplasia with intraperitoneal bleeding that was controlled and biopsied without removal. After discontinuing oral contraceptive use, the tumor regressed completely. The patient was followed up without recurrence for a 7 yr period. In a recent report, Edmondson and colleagues documented regression of liver cell adenomas in 3 cases following withdrawal of oral contraceptive use. Two cases were observed at 8 and 9 yr after withdrawal of the use of hormones, with 1 of these cases examined after death. An additional case involved a patient who underwent a left lobectomy of her liver for focal nodular hyperplasia. The patient was taking oral contraceptives and continued to do so for an additional 6 yr until an enlarged right lobe of the liver developed. It contained a 6 cm nodule that was biopsied, and the specimen was identical to the 1st nodule. The present case illustrates that when faced with an asymptomatic intrahepatic nodule, one can perform an open liver biopsy to establish the diagnosis, avoiding lobectomy and its attendant risks and possible morbidity. This case also emphasizes that even with increased vigilance in physical examinations of livers and liver scans on women who take long-term contraceptives, pedunculated nodules (which are not rare) may be missed by physical examination, liver scans and even angiography.