CURRENT ISSUE

ABSTRACT: Hepatocellular adenomas (HCA) are rare benign liver tumors associated with metabolic risk factors and carry a risk of malignant transformation. We present a case of a 50-year-old woman with a liver lesion initially diagnosed as a hepatocellular adenoma that showed progressive growth on follow-up imaging. Contrast-enhanced MRI (Magnetic Resonance Imaging) and CT (Computed Tomography) showed enlargement of the lesion in segments S6–S7. Initial biopsy findings were consistent with hepatocellular adenoma. Because of continued tumor growth, right liver resection was performed. Histopathological examination revealed foci of well-differentiated hepatocellular carcinoma arising within a dysplastic adenoma with areas of necrosis. This case highlights the diagnostic challenges in distinguishing hepatocellular adenoma from early hepatocellular carcinoma, particularly in patients with metabolic risk factors and progressive tumor enlargement. It emphasizes the importance of careful imaging surveillance and timely surgical management.

ABSTRACT: Type 2 diabetes mellitus is associated with an increased risk of several malignancies, prompting interest in the potential oncologic effects of antidiabetic therapies, particularly metformin. This study evaluated cancer-related adverse event reporting associated with metformin compared with other antidiabetic agents using real-world pharmacovigilance data from the FDA Adverse Event Reporting System (FAERS) between Q1 2023 and Q4 2024. A disproportionality analysis was conducted on over 3.2 million reports, including 66,187 metformin cases and 55,257 comparator cases comprising GLP-1 receptor agonists, SGLT2 inhibitors, sulfonylureas, and insulin. Reporting odds ratios (ROR), proportional reporting ratios (PRR), information components (IC), and chi-squared tests were applied across twelve pre-specified cancer types.
Metformin was associated with significantly lower reporting of hepatocellular carcinoma (ROR 0.377, 95% CI 0.181–0.782) and pancreatic carcinoma (ROR 0.669, 95% CI 0.493–0.908). In contrast, increased reporting signals were observed for prostate cancer (ROR 2.065, 95% CI 1.435–2.972), leukaemia (ROR 2.388, 95% CI 1.155–4.939), and breast cancer (ROR 1.404, 95% CI 1.023–1.926). Drug-specific comparisons indicated relatively lower overall cancer reporting for metformin compared with sitagliptin and empagliflozin, but higher reporting compared with insulin. Temporal analyses demonstrated variability in reporting patterns across study quarters.
These findings represent disproportionality signals reflecting reporting associations rather than causal effects and may be influenced by reporting bias, residual confounding, and differences in healthcare utilization. Overall, the results suggest a heterogeneous, cancer-type-specific reporting profile for metformin and highlight the value of pharmacovigilance analyses in generating real-world safety signals. Further confirmation in prospective and mechanistic studies is required.