A 28-year-old woman with a history of oral contraceptive use is found to have a 5 cm liver lesion on ultrasound. MRI shows a hypervascular mass without a central scar. She is advised to discontinue oral contraceptives because the lesion carries a significant risk of which complication?

• A Rupture and hemoperitoneum ✓
• B Transformation to cholangiocarcinoma
• C Development of hepatic encephalopathy
• D Autoimmune hepatitis

Explanation

This describes hepatic adenoma, which is strongly associated with estrogen (oral contraceptive) use. The most feared complication is spontaneous rupture causing hemoperitoneum, especially in lesions >5 cm. Discontinuation of OCPs may cause regression. Hepatic adenoma lacks bile ductules (distinguishing from FNH) and rarely transforms to HCC (unlike inflammatory/HNF-1alpha mutated subtypes, risk is low). Hepatic encephalopathy and autoimmune hepatitis are unrelated.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.