Systemic Contraceptives and Liver Tumors

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Abstract
That the agents in oral contraceptives may be implicated in the evolution of hepatic tumors in humans is based on reports that liver cell adenomas may reoccur in women in whom oral contraceptive use was continued after resection of an adenoma and unpublished reports that unresectable tumors decreased in size when oral contraceptive agents were withdrawn. A liver cell adenoma was observed in a woman treated with conjugated estrogens. In this patient the adenoma decreased in size when estrogens were withdrawn. The estrogenic component of oral contraceptives may be important in the formation and persistence of these tumors. Evidence that agents used in oral contraceptives may be causally related to the formation of liver tumors is circumstantial. Host and environmental factors may also be important. An epidemiologic survey coordinated by the Center for Disease Control and the Armed Forces Institute of Pathology (AFIP) was initiated. This survey will retrospectively review cases of hepatocellular tumors occurring in young women referred to Dr. Kamal Ishak at the AFIP since 1960. This investigative team will analyze a large number of host and environmental factors that may be important in the pathogenesis of these neoplasms in the setting of oral contraceptive use. These cases will also be reviewed by this investigative team to delineate all factors that may be involved in the pathogenesis of the tumors and to ascertain the incidence of these neoplasms in the USA.