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Transformation of Hepatic Cell Adenoma to Hepatocellular Carcinoma Due to Oral Contraceptive Use

Edwin J. Gyorffy, MD; James E. Bredfeldt, MD; and William C. Black, MD
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Requests for Reprints: William C. Black, MD, Department of Pathology, University of New Mexico, School of Medicine, 2211 Lomas Boulevard NE, Albuquerque, NM 87106.

Current Author Addresses: Dr. Gyorffy: University of Calgary, Health Sciences Center, Calgary, Alberta, Canada T2N 4N1.

Dr. Bredfeldt: Virginia Mason Clinic, Division of Gastroenterology, Seattle, WA 98111.

Dr. Black: Department of Pathology, University of New Mexico, School of Medicine, Albuquerque, NM 87106.

Ann Intern Med. 1989;110(6):489-490. doi:10.7326/0003-4819-110-6-489
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Although there is a causal relation between the use of oral contraceptives and hepatic cell adenoma (1), a similar relation between the use of oral contraceptives and hepatocellular carcinoma remains speculative. Studies of hepatocellular carcinoma in young women using oral contraceptives and other epidemiologic evidence suggest a possible causal relation (2-5). A more fundamental question is whether hepatic cell adenomas are premalignant and can transform into hepato-cellular carcinoma. We report the case of a long-term user of oral contraceptives in whom a hepatic cell adenoma, as shown by a biopsy sample, transformed into hepatocellular carcinoma.

Case Report: A 53-year-old white


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