An association between the use of oral contraceptives and the development of benign disease of the liver was first suggested by Baum et al. Since then there have been many reports of such an association and there is now firm evidence that the use
of
oral contraceptives increases the incidence of benign liver tumors and particularly of hepatocellular adenoma. But, a definite relationship between the oral contraceptive use and malignant liver tumors has not been established. Since the
mid-1970s,
there have been many reports of hepatocellular carcinoma in young women using oral contraceptives. Several abnormal characteristics associated with the pathology and natural history of hepatocellular carcinoma in young users of oral
contraceptives
have
also been noted. The tumors usually occur in non-cirrhotic lives without raised alpha fetoprotein concentration. This evidence, together with the occasional reports of malignancy progressing from benign adenoma, which is certainly associated
with
the
use of oral contraceptives, suggests that there could be a specific group of liver carcinomas related to oral contraceptives. Hepatocellular adenoma associated with the use of oral contraceptives had been reported in Korea, but hepatocellular
carcinoma
associated the use of oral contraceptives had not been reported. We experienced a cases of hepatocellular carcinoma without liver cirrhosis, markers of hepatitis infection, excess alcohol consumption, or known hepatotoxins, and it was confirmed
by
operation adn histologic examination.(Korean J Gastroenterol 1994 ; 26 : 1041-1047).
|