Development of Liver Cancers As an Unexpected Consequence of Anabolic Androgenic Steroid Use

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2023 Mar 6

PMID 36874750

Authors

Sameeha Khalid

Gieric Laput

Kamal Khorfan

Marina Roytman

Affiliations

Soon will be listed here.

Abstract

Although the relationship between androgens and hepatocellular tumor development has been noted since 1975, cases involving hepatocellular carcinoma (HCC) or cholangiocarcinoma development in patients on chronic androgen therapy or anabolic androgenic steroid (AAS) use are few, and far between. We present three cases of patients who developed hepatic and bile duct malignancies in the setting of AAS use and testosterone supplementation, arising from a single tertiary referral center. Additionally, we review the literature for the mechanisms behind the possible androgen-mediated malignant transformation of these liver and bile duct tumors.

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PMID: 39336089 PMC: 11429066. DOI: 10.3390/biology13090662.

References

Zhang H, Li X, Yang Y, Zhang Y, Wang H, Zheng X . Significance and mechanism of androgen receptor overexpression and androgen receptor/mechanistic target of rapamycin cross-talk in hepatocellular carcinoma. Hepatology. 2017; 67(6):2271-2286. PMC: 6106789. DOI: 10.1002/hep.29715. View

Solbach P, Potthoff A, Raatschen H, Soudah B, Lehmann U, Schneider A . Testosterone-receptor positive hepatocellular carcinoma in a 29-year old bodybuilder with a history of anabolic androgenic steroid abuse: a case report. BMC Gastroenterol. 2015; 15:60. PMC: 4461943. DOI: 10.1186/s12876-015-0288-0. View

Tesluk H, Lawrie J . Hepatocellular adenoma. Its transformation to carcinoma in a user of oral contraceptives. Arch Pathol Lab Med. 1981; 105(6):296-9. View

CHRISTOPHERSON W, MAYS E, Barrows G . A clinicopathologic study of steroid-related liver tumors. Am J Surg Pathol. 1977; 1(1):31-41. DOI: 10.1097/00000478-197701010-00004. View

Hardt A, Stippel D, Odenthal M, Holscher A, Dienes H, Drebber U . Development of hepatocellular carcinoma associated with anabolic androgenic steroid abuse in a young bodybuilder: a case report. Case Rep Pathol. 2012; 2012:195607. PMC: 3420693. DOI: 10.1155/2012/195607. View

CHRISTOPHERSON W, MAYS E . Liver tumors and contraceptive steroids: experience with the first one hundred registry patients. J Natl Cancer Inst. 1977; 58(2):167-71. DOI: 10.1093/jnci/58.2.167. View

Hernandez-Nieto L, Bruguera M, Bombi J, Camacho L, Rozman C . Benign liver-cell adenoma associated with long-term administration of an androgenic-anabolic steroid (methandienone). Cancer. 1977; 40(4):1761-4. DOI: 10.1002/1097-0142(197710)40:4<1761::aid-cncr2820400454>3.0.co;2-c. View

Weill B, Menkes C, Cormier C, Louvel A, Dougados M, Houssin D . Hepatocellular carcinoma after danazol therapy. J Rheumatol. 1988; 15(9):1447-9. View

Turani H, Levi J, Zevin D, Kessler E . Hepatic lesions in patients on anabolic androgenic therapy. Isr J Med Sci. 1983; 19(4):332-7. View

10.

Stoot J, Coelen R, Jong M, Dejong C . Malignant transformation of hepatocellular adenomas into hepatocellular carcinomas: a systematic review including more than 1600 adenoma cases. HPB (Oxford). 2010; 12(8):509-22. PMC: 2997656. DOI: 10.1111/j.1477-2574.2010.00222.x. View

11.

SHAHIDI N . A review of the chemistry, biological action, and clinical applications of anabolic-androgenic steroids. Clin Ther. 2001; 23(9):1355-90. DOI: 10.1016/s0149-2918(01)80114-4. View

12.

Mancinelli R, Onori P, DeMorrow S, Francis H, Glaser S, Franchitto A . Role of sex hormones in the modulation of cholangiocyte function. World J Gastrointest Pathophysiol. 2011; 1(2):50-62. PMC: 3097944. DOI: 10.4291/wjgp.v1.i2.50. View

13.

Woodward C, Smith J, Acreman D, Kumar N . Hepatocellular carcinoma in body builders; an emerging rare but serious complication of androgenic anabolic steroid use. Ann Hepatobiliary Pancreat Surg. 2019; 23(2):174-177. PMC: 6558130. DOI: 10.14701/ahbps.2019.23.2.174. View

14.

Nagasue N, Ito A, Yukaya H, Ogawa Y . Estrogen receptors in hepatocellular carcinoma. Cancer. 1986; 57(1):87-91. DOI: 10.1002/1097-0142(19860101)57:1<87::aid-cncr2820570118>3.0.co;2-k. View

15.

Krutsenko Y, Singhi A, Monga S . β-Catenin Activation in Hepatocellular Cancer: Implications in Biology and Therapy. Cancers (Basel). 2021; 13(8). PMC: 8069637. DOI: 10.3390/cancers13081830. View

16.

Johnson F, Lerner K, Siegel M, FEAGLER J, MAJERUS P, HARTMANN J . Association of androgenic-anabolic steroid therapy with development of hepatocellular carcinoma. Lancet. 1972; 2(7790):1273-6. DOI: 10.1016/s0140-6736(72)92649-9. View

17.

BOYD P, Mark G . Multiple hepatic adenomas and a hepatocellular carcinoma in a man on oral methyl testosterone for eleven years. Cancer. 1977; 40(4):1765-70. DOI: 10.1002/1097-0142(197710)40:4<1765::aid-cncr2820400455>3.0.co;2-y. View

18.

Yip T, Wong G, Chan H, Tse Y, Liang L, Hui V . Elevated testosterone increases risk of hepatocellular carcinoma in men with chronic hepatitis B and diabetes mellitus. J Gastroenterol Hepatol. 2020; 35(12):2210-2219. DOI: 10.1111/jgh.15079. View

19.

Kalra M, Mayes J, Assefa S, Kaul A, Kaul R . Role of sex steroid receptors in pathobiology of hepatocellular carcinoma. World J Gastroenterol. 2008; 14(39):5945-61. PMC: 2760195. DOI: 10.3748/wjg.14.5945. View

20.

Littlewood E, Barrison I, Murray-Lyon I, Paradinas F . Cholangiocarcinoma and oral contraceptives. Lancet. 1980; 1(8163):310-1. DOI: 10.1016/s0140-6736(80)90804-1. View