A case of liver cell adenoma diagnosed in the last trimester of the pregnancy

A 22 year old women, para 0, who never took oral contraceptive, suddenly developed upper abdominal pain. Abdominal US disclosed a huge mass echo in the right lobe of the liver. After Cesarian section, Abdominal CT and angiography revealed a large tumor in the liver. AFP was 404ng/ml and GOT was 349 units. Needle liver biopsy showed findings compatible with liver cell adenoma. Exploration and right lobe hepatectomy demonstrated a huge encapsultated tumor with focal necrosis and hemorrhage, mesuring 14×10×6cm. Histologically, tumor was composed of vacuolated and monotonous hepatic cells without portal tract, which are characteristic features of liver cell adenoma. Increasing numbers of liver cell adenoma in young women of childbearing age and association of use of oral contraceptive have been reported in abroads. In Japan, few cases of liver cell adenoma had been reported and they did not show any relation to oral contraceptive. Our case may suggest some relation between estrogen-progesteron balance and initiation or promotion of liver cell adenoma.