Oral contraceptives and benign tumors of the liver

In recent years the prevalence of benign tumors of the liver has increased to the point that they must now be considered in the differential diagnosis of a variety of symptoms in women at risk. It is important to distinguish hepatic adenoma from focal nodular hyperplasia for the former may be complicated by severe hemorrhage and is clearly linked to prolonged use of oral contraception. Focal nodular hyperplasia has an excellent prognosis and, despite some reports to the contrary, there is no clear evidence that synthetic hormone use has resulted in a change in the frequency of this tumor. It is estimated that the annual incidence of hepatic adenoma is now 3.4 cases per 100,000 oral contraceptive users and at this rate about 320 new cases are expected each year. There is no question that careful scrutiny of the group at risk offers the best chance of preventing serious morbidity from hepatic adenoma.