Kosaka A, Takahashi H, Yajima Y, Tanaka M, Okamura K, Mizumoto R, Katsuta K
Department of Surgery, Matsusaka City Hospital, Mie, Japan.
J Gastroenterol. 1996 Jun;31(3):450-4. doi: 10.1007/BF02355039.
We report herein the case of a 35-year-old woman with aplastic anemia who developed hepatocellular carcinoma after long-term therapy with oxymetholone. She was treated with 60 mg/day of oxymetholone for 3 years (total dose 64.8 g). Alpha-fetoprotein, hepatitis B surface antigen, and hepatitis C antibody were all negative, but serum titers of carcinoembryonic antigen and carbohydrate antigen were elevated. Lateral segmentectomy of the liver was performed. The histopathological findings were compatible with those of multiple hepatocellular carcinoma without liver cirrhosis. Three years since the operation, the patient is doing well and no signs of tumor recurrence have been detected. According to our review of Japanese cases of hepatocellular carcinoma associated with anabolic steroid therapy, in all instances the tumors developed after long-term administration of anabolic steroids for hematologic diseases. In patients under long-term anabolic steroid therapy, routine screening of the liver by ultrasonography and computed tomography should be performed to detect liver tumors in the early stages.
我们在此报告一例35岁再生障碍性贫血女性患者，其在长期使用羟甲烯龙治疗后发生肝细胞癌。她接受了每日60毫克羟甲烯龙治疗3年（总剂量64.8克）。甲胎蛋白、乙肝表面抗原和丙肝抗体均为阴性，但癌胚抗原和糖类抗原的血清滴度升高。进行了肝脏外侧段切除术。组织病理学检查结果与无肝硬化的多发性肝细胞癌相符。术后三年，患者情况良好，未检测到肿瘤复发迹象。根据我们对日本与合成代谢类固醇治疗相关的肝细胞癌病例的回顾，在所有病例中，肿瘤均在长期使用合成代谢类固醇治疗血液疾病后发生。对于长期接受合成代谢类固醇治疗的患者，应通过超声和计算机断层扫描对肝脏进行常规筛查，以便在早期发现肝脏肿瘤。
