Wang Lixia, Wang Cong, Li Wei, Meng Fanyang, Li Yuying, Fan Hongqiong, Zhou Yanhua, Bharathi Gnana, Gao Sujun, Yang Yan
Department of Hematology.
Department of Radiology, The First Hospital of Jilin University.
Medicine (Baltimore). 2020 Jul 10;99(28):e20829. doi: 10.1097/MD.0000000000020829.
Anabolic steroids are widely administered to patients with aplastic anemia (AA) and are associated with numerous medical complications. To assist with future diagnoses, we report about a young boy with multiple hepatocellular adenomas (HAs) induced by long-term use of anabolic androgenic steroids (AAS) for AA and present a related literature review.
A 15-year-old boy who was diagnosed with AA in 2011 had been treated with stanozolol (6 mg per day) and ciclosporin A (120-150 mg per day) for almost 4 years. He presented with epigastric pain and fever, and abdominal computed tomography showed a lesion of heterogenous density measuring 13.5 × 13.0 × 8.0 cm in the left hepatic lobe, which was initially misdiagnosed as a liver abscess.
The patient went into hemorrhagic shock twice after invasive manipulation that aimed at diagnosis and was finally diagnosed with HA using fine needle aspiration.
The patient discontinued AAS and only reserved ciclosporin A for AA treatment.
Follow-up abdominal computed tomography performed 4 years after AAS discontinuation showed obvious regression of the hepatic lesions.
It is of great importance for hematologists to completely understand that the long-term use of AAS may cause HA, which carries a great risk of hemorrhage and malignant transformation.
合成代谢类固醇被广泛应用于再生障碍性贫血（AA）患者，且与多种医学并发症相关。为辅助未来的诊断，我们报告了一名因长期使用合成代谢雄激素类固醇（AAS）治疗AA而诱发多发性肝细胞腺瘤（HA）的小男孩，并进行相关文献综述。
一名2011年被诊断为AA的15岁男孩，使用司坦唑醇（每日6毫克）和环孢素A（每日120 - 150毫克）治疗近4年。他出现上腹部疼痛和发热，腹部计算机断层扫描显示左肝叶有一个大小为13.5×13.0×8.0厘米的密度不均匀病变，最初被误诊为肝脓肿。
患者在旨在诊断的侵入性操作后两次发生失血性休克，最终通过细针穿刺确诊为HA。
患者停用AAS，仅保留环孢素A用于AA治疗。
停用AAS 4年后进行的随访腹部计算机断层扫描显示肝脏病变明显消退。
血液科医生充分认识到长期使用AAS可能导致HA非常重要，HA存在大出血和恶变的巨大风险。
