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THE LIVER AND STEROID HORMONES

In this issue of the Journal 2 reports of single cases of hepatocellular carcinoma are reported. Contraceptive steroids were associated with 1 and androgens with the other. Benign hepatomas have been produced in rats only after 2 years administration of doses 50-6250 times the human oral contraceptive dose. In humans hepatoma formation may be related more to duration or dose level than to any particular steroid hormone. Focal nodular hyperplasia is the most characteristic liver lesion attributed to oral contraceptives. In women taking the pill an increasing incidence of hepatic adenoma has also been recorded. Also the association between long-term androgen therapy and hepatocellular carcinoma has been suspected. With the noninvasive techniques of ultrasonography liver scintigraphy and computerized axial tomography liver surveillance is now feasible. The question of regularly taking hormonally active substances to alter the normal metabolism should be kept under review. It is questioned if these drugs should be used for long periods to alter human physiology.