Martin Nicole M, Abu Dayyeh Barham K, Chung Raymond T
Massachusetts General Hospital, WRN 1007, Boston, MA 02114, USA.
World J Gastroenterol. 2008 Jul 28;14(28):4573-5. doi: 10.3748/wjg.14.4573.
Anabolic steroid abuse is common among athletes and is associated with a number of medical complications. We describe a case of a 27-year-old male bodybuilder with multiple hepatic adenomas induced by anabolic steroids. He initially presented with tumor hemorrhage and was treated with left lateral hepatic segmentectomy. Regression of the remaining tumors was observed with cessation of steroid use. However, 3 years and a half after his initial hepatic segmentectomy, he presented with recurrent tumor enlargement and intraperitoneal hemorrhage in the setting of steroid abuse relapse. Given his limited hepatic reserve, he was conservatively managed with embolization of the right accessory hepatic artery. This is the first reported case of hepatic adenoma re-growth with recidivistic steroid abuse, complicated by life-threatening hemorrhage. While athletes and bodybuilders are often aware of the legal and social ramifications of steroid abuse, they should continue to be counseled about its serious medical risks.
合成代谢类固醇滥用在运动员中很常见,且与多种医学并发症相关。我们描述了一例27岁男性健美运动员因合成代谢类固醇诱发多发性肝腺瘤的病例。他最初因肿瘤出血就诊,接受了左肝外侧段切除术。停用类固醇后,观察到其余肿瘤消退。然而,在首次肝段切除术后3年半,他在合成代谢类固醇滥用复发的情况下出现肿瘤复发增大及腹腔内出血。鉴于其肝脏储备有限,对他采取了右肝副动脉栓塞的保守治疗。这是首例因复发性类固醇滥用导致肝腺瘤再生长并伴有危及生命的出血的报道病例。虽然运动员和健美运动员通常知晓类固醇滥用的法律和社会后果,但仍应持续向他们提供关于其严重医学风险的咨询。