Reasonable surgical treatment for tumors of the liver associated with the use of oral contraceptives.

3 new patients added to a previously reported series of 6 patients evincing the association of benign hepatic adenoma or focal nodular hyperplasia of the liver and oral contraceptive (OC) ingestion are reported on; in addition some new follow-up material on the 6 previously reported patients is supplied. All 9 patients underwent 7 emergency-type and 8 elective operations. All had right-side tumors and 3 patients had left-sided tumors as well. All emergency procedures were performed for right-sided hepatic tumors. 1 patient died after a right total lobectomy done as an emergency and the remaining 8 are alive and asymptomatic. 3 were known to be hemorrhaging from unknown cause. 3 were thought to have acute digestive disease. 3 were correctly diagnosed preoperatively. 8/9 patients had previously undergone diagnostic evaluation for vague pain in the abdomen. A possible recurrence in 1 patient has not yet been proven. The liver scan is recommended as the best method of establishing the diagnosis and for continuing evaluation. No specific OC was implicated. Estrogen receptor values of the liver and of the tumor were obtained in 4 patients but results were inconclusive. All women ingesting OCs who have nonspecific abdominal pain must be evaluated by liver scan. Reasonable operative treatment focuses on minimizing the risk for the patient and preserving normal anatomic structure. Detected adenomas of the liver should be removed electively to avert hemorrhage. Postoperatively these patients must discontinue taking OCs and should be subjected to liver scan periodically.