Hepatic Adenomas in Adolescents and Young Women with Endometriosis Treated with Norethindrone Acetate

Paula C. Brady, Missmer SA, Stacey A. Missmer, Laufer MR, Marc R. Laufer
Journal of Pediatric and Adolescent Gynecology · 2016 · vol. 30(3) , pp. 422–424 · doi:10.1016/j.jpag.2016.12.002 · PMID:28024920 · W2566654829
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This paper investigated the occurrence and characteristics of hepatic adenomas in adolescent and young women diagnosed with endometriosis and treated with norethindrone acetate.

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Abstract

BackgroundEndometriosis-ectopic implantation of endometrial-like tissue-affects 10% of female adolescents and adults. First-line treatment includes progesterone only (such as norethindrone acetate [NET-A]) or combined estrogen/progestin oral contraceptive pills. Estrogen-containing contraceptives confer increased risk of hepatic adenomas, whereas the association with NET-A is very rarely reported.CaseThree adolescents with stage I to II endometriosis managed with NET-A (up to 15 mg/d for 28-78 months) were diagnosed with hepatic adenomas at ages 17-22 years. They previously received estrogen-containing medications, which were stopped 24 months or longer before diagnosis of hepatic adenoma.Summary and conclusionNET-A in a dose greater than 10 mg/d might be associated with increased risk for hepatic adenomas, likely due to peripheral conversion to ethinyl estradiol. Use of NET-A might not be advisable in patients with known hepatic adenomas.

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Condition tags

endometriosis

MeSH descriptors

Adenoma Contraceptives, Oral, Hormonal Endometriosis Liver Neoplasms Norethindrone Adenoma Adenoma Adolescent Adult Contraceptives, Oral, Hormonal Contraceptives, Oral, Hormonal Endometriosis Ethinyl Estradiol Ethinyl Estradiol Female Humans Liver Neoplasms Liver Neoplasms Magnetic Resonance Imaging Norethindrone

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