Possible cause-effect relation between estrogen and focal nodular hyperplasia: case report

A 22-year-old female patient sought medical care due to an asymptomatic solid nodule in the liver, incidentally diagnosed by abdominal ultrasound. She reported the use of an estrogen-based oral contraceptive for approximately 3 years. She denied smoking or alcohol drinking. Her mother had a history of nonalcoholic steato-hepatitis and her maternal grandmother had a hepatic hemangioma. Physical examination revealed an asymptomatic patient with discretely painful palpation of the right hypochondrium close to the xiphoid appendix. Ultrasound examination revealed a 5.9 x 4.1 cm hypoechogenic nodule in the left lobule and computed tomography revealed a 5.3 x 6.3 x 4.5 cm focal lesion in the 2/3 segments...(AU) Paciente do sexo feminino, 22 anos, procurou auxilio medico devido a um nodulo solido no figado, assintomatico, diagnosticado incidentalmente por ultrassonografia de abdome. Relatava uso de anticoncepcional oral, a base de estrogeno, por cerca de 3 anos. Negava tabagismo e etilismo. Mae apresentava historia de esteato-hepatite nao alcoolica e avo materna era portadora de hemangioma hepatico. Ao exame fisico, apresentava-se assintomatica, com palpacao discretamente dolorosa do hipocondrio direito proximo ao apendice xifoide. Ao exame ultrasonografico apresentava um nodulo hipoecogenico no lobulo esquerdo de 5,9 x 4,1 cm e a tomografia computadorizada apresentava lesao focal nos segmentos 2/3 de 5,3 x 6,3 x 4,5 cm...(AU)