Hepatic haemangiomas: possible association with female sex hormones.
Level 3 - non-randomized controlled study
Prospective non-randomized cohort study
PubMed 15306599 · doi:10.1136/gut.2003.038646
What was done
A prospective cohort study followed 94 women with 181 ultrasound-diagnosed hepatic haemangiomas for 1 to 17 years (mean 7.3 years, standard deviation 5.5). Lesion location, number, size, and ultrasonographic pattern were monitored over time. Participants completed questionnaires regarding gynaecological and reproductive history, and changes in haemangioma number and size were compared between 22 patients receiving exogenous hormone therapy and 72 unexposed controls.
What was found
Age at first period was inversely correlated with haemangioma size (r = 0.181, p = 0.015), and age at menopause was positively correlated with the number of baseline haemangiomas (r = 0.542, p < 0.0001). Lesion enlargement occurred in 5 of 22 (22.7%) hormone therapy users compared to 7 of 72 (9.7%) unexposed controls. Three variables independently predicted lesion growth: hormone therapy (p = 0.05), a hypoechoic pattern versus a hyperechoic pattern (p = 0.003), and a lower total number of haemangiomas at baseline (p = 0.006). No changes in lesion count or ultrasound pattern occurred during follow-up.
Why it matters
This study provides prospective evidence that both endogenous and exogenous female sex hormones can influence hepatic haemangioma natural history, supporting periodic ultrasound monitoring for women on hormone therapy.
Limits
The total sample size was small with only 22 hormone-exposed patients and 12 total progression events across the entire cohort. Follow-up duration varied widely from 1 to 17 years. The abstract does not detail specific hormone regimens, dosages, indications for therapy, or control for potential baseline confounders between groups.
Cited by
- context Hepatic hemangiomas are estrogen-sensitive benign vascular clusters that shrink in postmenopausal women.