- 期刊
Regression of Multiple Liver Adenomas after Withdrawal of Oral Contraceptives in a Hepatitis C Virus Carrier
肝內多發性肝腺瘤經停用避孕丸後消失：發生於一慢性C型肝炎帶原之病例報告
摘要
我們報告一例發生於無症狀之慢性C型肝炎帶原者肝內之多發性肝腺瘤，該名40歲女性，曾連續服用口服避孕丸長達15年。在腹部超音波檢查時發現肝臟內有多個低回音至中回音結節，電腦斷層掃描及核磁共振影像檢查也發現肝臟內有多個大小不一之腫瘤，其中位於肝臟第四節之腫瘤為最大，直徑約7公分，這些腫瘤在血管攝影檢查時呈高血流病灶。肝生檢病理學檢查呈現典型肝腺瘤，且無惡性變化。在病患停用避孕丸後，這些肝內腫瘤呈現明顯萎縮，經18個月後，腹部超音波追蹤檢查發現原先之肝內腫瘤幾乎消失。因此，我們建議對於避孕丸導致之多發性肝線瘤，應先停用避孕丸，並以腹部超音波或電腦斷層掃描作密切追蹤檢查。
並列摘要
We report on a case of multiple liver adenomas in a hepatitis C virus (HCV) carrier. A 40-year-old woman was asymptomatic and has been taking oral contraceptives continuously for 15 years. Abdominal ultrasonography revealed multiple iso-and hypoechoic tumors in both lobes of the liver. Enhanced computed tomography (CT) and magnetic resonance imaging demonstrated multiple hypervascular tumors in the lives; with the biggest one at segment Ⅳ, which measured 7cm in diameter. Cellar angiography revealed multiple hyervascular tumor staining of varying sizes in the liver. Histologically, the tumor showed features typical of a liver cell adenoma with no evidence of malignant transformation. These tumors progressively decreased in size and number after the patient discontinued the use of oral contraceptives. Eighteen months after the initial diagnosis, these tumors had almost completely disappeared on follow-up abdominal ultrasonography. We suggest that in an asymptomatic patient with contraceptives-related multiple liver adenomas, discontinuing the use of oral contraceptives is one of the choices of treatment, and close follow-up by ultrasonography or CT is mandatory.