Bleeding From Adenoma of the Liver

To the Editor .–The case report by Andersen and Packer ( Arch Surg 3:898, 1976) provides information on a bleeding but temporarily unresected liver cell adenoma in a woman taking oral contraceptives at the time of diagnosis. The failure to grow perceptibly or to undergo further hemorrhage before the subsequent resection 18 months later led the authors to question the need for routine resection of these adenomas if oral contraceptives are withdrawn. I would like to point out the letter by Model et al. 1 A bleeding adenoma was removed from a woman who had taken oral contraceptives for six years but had stopped nine months before the hemorrhage. I know of two other cases of hemorrhage from liver cell adenoma in women who had never used hormones, and two cases of women who had taken hormones, stopped in order to become pregnant, and who then sustained hemorrhage into the adenoma