A case of hepatocyte nuclear factor 1α-inactivated hepatocellular adenoma associated with low-dose estrogen progestin use

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  • LEP服用患者に生じたHNF-1α不活化型肝細胞腺腫の1例
  • 症例報告 LEP服用患者に生じたHNF-1α不活化型肝細胞腺腫の1例
  • ショウレイ ホウコク LEP フクヨウ カンジャ ニ ショウジタ HNF-1aフカツカガタ カン サイボウセン シュ ノ 1レイ

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<p>Hepatocellular adenoma (HCA), a rare benign liver tumor, occurs particularly in women taking low-dose estrogen progestin (LEP). We report one case of hepatocyte nuclear factor 1α-inactivated (H)-HCA associated with LEP use. A 29-year-old woman was referred to our hospital for examination of abnormal cervical cytology. Histological diagnosis on conization was adenocarcinoma in situ. Computed tomography revealed a 4.6 cm liver tumor in segment 4. We suspected H-HCA as she had been taking LEP for four years, and magnetic resonance imaging showed that the tumor was hypointense on opposed phase compared with in-phase T1W images. One year after the discontinuation of LEP, the size of the tumor did not change, and she was planning to conceive. Therefore, she underwent laparoscopic partial hepatectomy of segment 4. The tumor was composed of hepatocytes without nuclear atypia, and immunohistochemically showed an absence of liver fatty acid binding protein in the tumor, but presence in the background. These findings were consistent with those of H-HCA. Three months after resection, she had a pregnancy that reached term, and she delivered without any complications. Thus, while prescribing long-term LEP, HCA should be considered. [Adv Obstet Gynecol, 71(1) : 22-29, 2019 (H31.2)]</p>

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