Inflammatory hepatocellular adenoma in a patient with Turner's syndrome: A case report

Satoshi Nemoto; Shun-Ichi Ariizumi; Yoshihito Kotera; Akiko Omori; Shingo Yamashita; Taka-Aki Kato; Shota Aoyama; Hiroto Egawa; Masakazu Yamamoto

doi:10.1016/j.ijscr.2019.02.017

Inflammatory hepatocellular adenoma in a patient with Turner's syndrome: A case report

Int J Surg Case Rep. 2019:56:5-9. doi: 10.1016/j.ijscr.2019.02.017. Epub 2019 Feb 15.

Authors

Satoshi Nemoto¹, Shun-Ichi Ariizumi², Yoshihito Kotera³, Akiko Omori³, Shingo Yamashita³, Taka-Aki Kato³, Shota Aoyama³, Hiroto Egawa³, Masakazu Yamamoto³

Affiliations

¹ Department of Gastroenterology Surgery, Tokyo Women's Medical University, Japan. Electronic address: nemoto.satoshi@twmu.ac.jp.
² Department of Gastroenterology Surgery, Tokyo Women's Medical University, Japan. Electronic address: s_nemoto32@hotmail.co.jp.
³ Department of Gastroenterology Surgery, Tokyo Women's Medical University, Japan.

Abstract

Introduction: Hepatocellular adenoma (HCA) is a rare benign tumor and is related to the use of an oral contraceptive pill. Turner's syndrome requires various hormone replacement therapies, including the pill which is used as a female hormone replacement therapy. Herein we report a case of Turner's syndrome with HCA treated by liver segmentectomy.

Presentation of case: A 36-year-old woman with Turner's syndrome was treated with oral contraceptive pills as a female hormone replacement therapy for 20 years. She presented with fatigue and liver tumor. Liver tumors in the posterior lobe measuring 60 mm and 10 mm in diameter were detected on CT; hence, she was referred to our department. Both the tumors showed high intensity in the arterial phase, iso-intensity in the portal and late phases, and low intensity in the hepatobiliary phase on Gb-EOB-MRI. She was diagnosed with multiple HCAs and underwent segmentectomy Section 7. Pathologically, both the tumors were diagnosed as HCAs, and inflammatory markers were detected by immunohistochemistry. Thirteen months postoperatively, she was doing well and there was no evidence of recurrence of HCA without the pill.

Discussion: There is only one report of HCA in patients with TS (Espat et al., 2000). We reported a case of multiple HCAs in a patient with TS underwent hepatectomy.

Conclusion: With the use of the contraceptive pill as a long-term female hormone replacement therapy for Turner's syndrome, careful attention is required for HCA.

Keywords: Case report; Hepatocellular adenoma; Hormone replacement therapy; Surgical resection; Turner’s syndrome.