Women who use birth control methods that rely on hormone manipulation, or those taking hormone replacement therapy, should be aware of how these drugs can affect the liver.
An adenoma of the liver, a common and benign tumor, can develop if a woman has consistently relied on these hormones.
Before self-diagnosing or worrying, though, keep in mind that the relationship between contraceptive use and likelihood of liver cell adenoma depends on the age of the user as well as the dosage and duration of treatment.
The good news is that adenomas usually degenerate when patients stop taking these drugs.
What Is a Hepatic Adenoma?
These rare benign liver tumors are typically linked to changes in hormone levels. Hemorrhaging would be a common concern when operating on these tumors, but most often they are solitary, meaning surgery would be low risk. When more than one of these tumors are present, it is known as a hepatic adenomatosis – indicating between 10 and 50 adenomas and is unlikely due to hormone fluctuations.
In addition to oral contraceptive and hormone replacement therapy, pregnancy is also related to the development of a single adenoma. Patients with type I glycogen storage disease (also known as Von Gierke disease – a condition where glycogen cannot be broken down) are at increased risk for hepatic adenomatosis.
Women over 30 who have used certain oral contraceptives for more than two years are at the highest risk for a liver adenoma. The likelihood of developing this condition increases exponentially depending on years of use and dosage.
What are the Symptoms of Hepatic Adenoma?
These growths often reveal no symptoms at all. Rather, they may remain unnoticed until they rupture. This will lead to extensive abdominal pain, and it can progress to more serious conditions if untreated.
Other signs to note include:
Upper-Right Quadrant Discomfort
One common warning of this condition is pain or fullness in the upper-right area of the abdomen, which houses the liver, gallbladder and more.
A person suffering from pain or discomfort in this area should seek treatment.
Symptoms of a more advanced complication, like liver cancer, include unexpected weight loss, gastrointestinal issues, jaundice, abdominal pain and swelling and fatigue.
In conjunction with oral contraceptive use, hormone replacement therapy and anabolic steroids, hepatic adenomas and other liver problems are complicated by hepatitis B and C, Cirrhosis of the liver and aflatoxin exposure.
Consult a specialist if you are suffering from these issues.
In addition to ceasing oral contraception use or hormone replacement therapy, your doctor will also urge you to stop smoking and limit drinking.
What to Expect
If diagnosed with a liver adenoma, it is possible the benign tumor will eventually rupture and lead to bleeding, or though unlikely, it may progress into a more complicated problem, like liver cancer. This is evident in less than 10% of adenoma cases, though.
A biopsy is the most dependable method of diagnosing a hepatic adenoma. The most common complications experienced include natural ruptures of the tumors as well as development into hepatocellular carcinomas – the most common type of liver cancer.
When experiencing these issues, patients will consult with a specialist to determine problems with adenomas or other liver complications.
If one or more of these tumors are present, the professional will urge lifestyle changes. For example, female patients will be counseled to stop hormone medication or treatments. Avoiding future pregnancies will also be advised, since this has been linked to further problems in the liver.
Though rare, the diagnosis of an adenoma prompts regular, long-term medical care. Even if the growth recedes, the possibility of developing liver cancer at a later point is still a possibility. However, after single liver adenomas have been removed, the likelihood of developing a new growth or it progressing into liver cancer is minimal.
In fact, surgical removal is often argued as the best treatment method because of the long-term efficacy of these procedures. There are circumstances, though, that require greater care and often involve more complications:
- Multiple Tumors. With hepatic adenomatosis, surgical decisions and treatment options are more complicated. This is simply more complicated than a single adenoma, as the risk for hemorrhage and comparable issues is much higher.
- Large Tumors. Tumors up to 4 inches in diameter may lead to deformation of the liver. This is called a “massive type,” and it also carries a greater risk of complications during treatment, as well as long-term problems down the road.
Regardless of the type, size or amount of adenomas, patients will undergo a continued medical plan that includes scanning and frequent tests that check for liver cancer and pinpoint rising levels of certain proteins.
These tests are vitally important. They are used to measure the growth of the adenoma as well as any other developments that can help specialists identify alterations that may indicate liver cancer.
Treatment Options for Hepatic Adenoma
As mentioned, following a biopsy to detect the adenoma(s), surgical removal of the tumor is one of the most successful treatment options. This reduces the possibility of hemorrhaging and is the best way for a medical team to accurately diagnosis and treat the growth.
However, simply restricting the use of oral contraceptives and other hormone modifiers may be enough for the most basic adenomas (i.e., small, solitary and superficial) to recede. Regardless, the patient will be advised to stop using these and similar inhibitors.
The success of this method depends on when these items are restricted, so it is important to stop as soon as possible. For adenomatosis and otherwise inoperable cases, embolization therapy may be an option. In this case, blood flow to the tumor’s cells will be blocked to impede development.
Find Out More
Even thinking about an issue like a hepatic adenoma can be unnerving. However, if you are working with a qualified medical team, you can rest easy knowing you will receive the best information and care possible. Make sure you find some of the top medical service in the nation to handle your diagnosis and treatment.
Operating out of the Hodes Comprehensive Liver and Pancreas Center at the University of Maryland St. Joseph Medical Center outside of Baltimore, Dr. Fraiman is one of the most qualified and experienced liver and pancreatic surgeons in the country. He specializes in liver and pancreatic research treatment.
Named by Baltimore Magazine as “Top Doc” for 7 years in a row, you can rest assured you will receive devoted attention and care, no matter the situation you are experiencing.
Contact us for more information, and make sure you are working with a team that has a track record of success.