+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Primary adenoma of the liver with spontaneous rupture following long-term intake of gestagens. Case report



Primary adenoma of the liver with spontaneous rupture following long-term intake of gestagens. Case report



Der Internist 24(5): 286-288



A case report of a 26-year old woman on chronic hemodialysis for pyelonephritis who took 10 mg of norethisterone acetate daily for suppression of menstruation. 1 week before admission colic-like pains appeared in right upper abdominal quadrant which were relieved by spasmolytics. Laboratory parameters (except those related to renal insufficiency), physical examination, x-rays of chest, stomach and biliary tract showed no abnormalities. Sonography revealed various round space-occupying lesions in the lower liver lobe. Before further studies could be initiated and following a hemodialysis session patient died of an intrahepatic hemorrhage confirmed by ultra-sonic and CAT-scan. Autopsy showed a large hematoma with more than 700 ml coagulated blood which caused rupture of the right liver lobe. Round adenomas were found in both lobes. The relationship between oral contraceptives and primary liver adenomas in young women without previous liver disease has been reported in the literature since 1973. 200 cases were found in the literature since 1977. Although mostly estrogens are blamed for liver adenomas, in this case it was a pure progestogen preparation. In another study of women with primary liver adenomas only 1 in 100 women used a pure progestin contraceptive. A relationship between androgens or anabolic steroids has been found in a number of case reports in the literature. It can be assumed that both combination preparations with estrogen components, and pure progestin preparations play a similar role in the pathogenesis of benign liver tumors.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 044031046

Download citation: RISBibTeXText

PMID: 6347951


Related references

Spontaneous rupture of a liver cell adenoma after long term methyltestosterone: report of a case successfully treated by emergency right hepatic lobectomy. British Journal of Surgery 66(3): 212-213, 1979

Spontaneous rupture of the liver associated with a primary angiosarcoma: case report. American Journal of Forensic Medicine and Pathology 21(2): 134-137, 2000

Spontaneous Rupture of the Liver After Delivery at Term. Review of the Literature with a Case Report. Journal of Obstetrics and Gynaecology of the British Commonwealth 70: 1060-1062, 1963

Spontaneous rupture of renal angiomyolipoma with tuberous sclerosis during long-term follow-up: a case report. Hinyokika Kiyo. Acta Urologica Japonica 47(9): 645-648, 2001

Long-term course of liver rupture in preeclampsia. A case report. Ginecologia Y Obstetricia de Mexico 68: 353-356, 2000

Hemorrhage from spontaneous rupture of a parathyroid adenoma (a case report). Ear Nose and Throat Journal 72(12): 794-799, 1993

Hemorrhage caused by ruptured liver cell adenoma following long-term oral contraceptives: a case report. Hepato-Gastroenterology 45(19): 224-225, 1998

Spontaneous rupture of an adrenal adenoma managed by laparoscopic adrenalectomy: a case report. Journal of the Medical Association of Thailand 97(1): 123-125, 2014

Late Surgical Treatment for Spontaneous Rupture of Hepatocellular Adenoma: Case Report. Arquivos Brasileiros de Cirurgia Digestiva 28(4): 297-299, 2016

Spontaneous rupture of a parathyroid adenoma presenting as a massive cervical hemorrhage: report of a case. Surgery Today 31(3): 222-224, 2001

Long-term survival after spontaneous rupture of a malignant rhabdoid tumor of the liver. Journal of Pediatric Surgery 37(10): 1488-1490, 2002

A case of primary yolk sac tumor of the liver with spontaneous rupture. Nihon Shokakibyo Gakkai Zasshi 78(8): 1668-1672, 1981

Long-term observation and functional state of the esophagus after primary repair of spontaneous esophageal rupture. Annals of Thoracic Surgery 81(5): 1858-1862, 2006

Spontaneous rupture of the liver in pregnancy; report of a case. Obstetrics and Gynecology 7(1): 40-43, 1956

Spontaneous rupture of the liver during pregnancy: a case report. Journal of Obstetric Gynecologic and Neonatal Nursing 18(2): 106-113, 1989