Hepatic lesions in patients treated with synthetic anabolic steroids

SYNOPSIS Hepatic abnormalities are described in three patients who received synthetic anabolic steroids. A child with Fanconi's anaemia was treated for four years and at necropsy the liver showed generalized hyperplasia, hyperplastic nodules, and a benign hepatoma. Two adults received only three months ' therapy with synthetic androgens; in one there was generalized hepatic hyperplasia and in the other widespread nodular hyperplasia. It is suggested that anabolic steroids may induce tumours through intermediate hyperplastic lesions, a sequence similar to that seen during tumour induction by carcinogens in experimental animals. Although it appears clear on the basis of a number of case reports that liver tumours in man are significantly associated with the administration of synthetic anabolic steroids, the mechanisms involved have not yet been elucidated. In the majority of these case reports there is no description of the liver parenchyma but occasionally the tumours have been said to arise in a normal liver or in one which show