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Since 1973, there has been an increase in the reported number of cases of liver tumors (both benign and malignant), associated with the intake of male hormones as anabolic steroids and oral contraceptives. Because these tumors are very rare in the younger age groups, and because there are approximately 50 million women taking oral contraceptives at the present time, there is a definite need for a large-scale epidemiological investigation to clarify this possible association.

The preliminary results of a prospective study of androgen therapy in the treatment of bone marrow insufficiency in children are reported. This study includes 11 children with the Fanconi syndrome, 21 idiopathic and 3 with toxic aplastic anaemia. Nine patients died early in the course of treatment. Impaired liver function was observed in 28% of patients and virilization in 37% of patients.

The authors report the case of a 28-year-old man with a solitary adenoma of the liver. The tumor was detected because of a raised erythrocyte sedimentation rate and serum fibrinogen. Review of the literature shows that adenoma of the liver is an uncommon tumor in man since only 30 other cases have been reported. The tumor is often multiple (55 p. 100) and the clinical manifestations are quite different from those observed in women: the adenoma is often asymptomatic (45 p. 100) and rupture is rare (10 p. 100). Androgens seem to be implicated in the development of adenoma in man since 8 out of 31 patients had received androgens for a long period of time; androgens also seem to favor the tumor's rupture.

Three patients with drug-induced hypoplastic anemia terminating 2 to 6 years after presentation with erythroleukemia are described. All were treated for prolonged periods with androgen and corticosteroid and two of the patients showed apparent dependence on this therapy for optimal hematologic status. The leukemic phase was heralded by loss of this dependence and development of sideroblastic dyserythropoiesis with progression to bizarre erythroid hyperplasia and fatal cytopenia. The exact relationship between androgen and corticosteroid therapy and the erythroleukemia remains speculative.