In Reply.—We thank Dr Knowles et al for their interest and comments regarding our article.
We offer no apologies, however, for the title of our article and do not believe that it is misleading to emphasize the life-threatening potential danger of an otherwise benign liver tumor that should be surgically removed when first discovered. The title simply defines the syndrome, with hemorrhage, the only variable expression.
We agree completely that precise classification is necessary in medicine. Unfortunately, where benign hepatic tumors are concerned, even those associated with oral contraceptives, there is, as yet, no system of nomenclature that is universally accepted. Neither have the individual entities been adequately described in the literature. Although a number of names have been pinned on the "pill"-associated tumors, we have designated them as "adenomas" because it seems to be the term most accepted for the tumors we have encountered. Those we have reported