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BMC Gastroenterology
Published in: BMC Gastroenterology 1/2015

Open Access 01-12-2015 | Case report

Testosterone-receptor positive hepatocellular carcinoma in a 29-year old bodybuilder with a history of anabolic androgenic steroid abuse: a case report

Authors: Philipp Solbach, Andrej Potthoff, Hans-Jürgen Raatschen, Bisharah Soudah, Ulrich Lehmann, Andrea Schneider, Michael J. Gebel, Michael P. Manns, Arndt Vogel

Published in: BMC Gastroenterology | Issue 1/2015

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Abstract

Background

Continuous use of anabolic androgenic steroid in high-doses is associated with substantial health risks, including hepatocellular adenoma. Malignant transformation from hepatocellular adenoma to hepatocellular carcinoma after anabolic androgenic steroid abuse has been rarely reported. The morphological distinction of adenoma from well-differentiated hepatocellular carcinoma is challenging and requires elaborated imaging techniques and histology.

Case presentation

We report about a 29-year old male professional bodybuilder who presented with mid-epigastric pain at the emergency unit. Ultrasound showed a severe hepatomegaly with multiple lesions. Contrast-enhanced ultrasound revealed a heterogeneous pattern with signs of hepatocellular carcinoma. CT scan of the abdomen confirmed multiple hypervascular lesions and central areas of necrosis without contrast enhancement. Subsequent diagnostics included fine needle aspiration (FNA) of suspicious lesions and mini-laparoscopy to establish the diagnosis of a β-catenin and testosterone-receptor positive hepatocellular carcinoma embedded in multiple adenomas. The patient was subsequently treated by liver transplantation and remains tumor-free 27 month after surgery.

Conclusion

Hepatocellular carcinoma occurring in association with anabolic androgenic steroid abuse should sensitize physicians and especially professional bodybuilders for the harmful use of high doses of steroids.
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Metadata
Title
Testosterone-receptor positive hepatocellular carcinoma in a 29-year old bodybuilder with a history of anabolic androgenic steroid abuse: a case report
Authors
Philipp Solbach
Andrej Potthoff
Hans-Jürgen Raatschen
Bisharah Soudah
Ulrich Lehmann
Andrea Schneider
Michael J. Gebel
Michael P. Manns
Arndt Vogel
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2015
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-015-0288-0

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