The benign hepatic lesion associated with long-term oral contraceptive use is best described as which of the following?

• A. Hepatic Adenoma
• B. Focal Nodular Hyperplasia
• C. Hemangioma
• D. Cavernous Hemangioma

Answer: (A)

Estrogen exposure from long-term oral contraceptives stimulates growth of a hepatocellular tumor that occurs most often in young, reproductive-age women. This benign lesion, hepatic adenoma, arises in the liver without normal portal tracts or bile ducts and tends to enlarge with ongoing estrogen exposure but may shrink when the contraceptive is stopped. It carries a real risk of intralesional bleeding and, in some cases, rare malignant transformation, which is why stopping the OC is advised if a hepatic adenoma is found. Other vascular liver lesions, like focal nodular hyperplasia, are not strongly tied to hormone use and often show features such as a central scar, while hemangiomas are congenital vascular lesions not driven by hormones. Thus the lesion most classically linked to long-term oral contraceptive use is hepatic adenoma.