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Hepatocellular carcinoma in a 10-month-old biliary atresia child
Taku Iida1, Ivan R Zendejas, Liise K Kayler
1Division of Transplantation and Hepatobiliary Surgery, Department of Surgery, College of Medicine, University of Florida, Gainesville, FL 32610-0286, USA.
Insights
We report a rare case of a 10-month-old boy with biliary atresia (BA) who developed hepatocellular carcinoma (HCC) and successfully underwent liver transplantation. This highlights the importance of monitoring for HCC in infants with BA.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Surgical Oncology
Background:
- Biliary atresia (BA) is a severe neonatal liver disease.
- Hepatocellular carcinoma (HCC) is rare in infants, especially those with BA.
- Early diagnosis and management are crucial for outcomes.
Observation:
- A 4-month-old infant presented with jaundice, hepatomegaly, and coagulopathy, initially diagnosed with neonatal hepatitis.
- Evaluation revealed cirrhosis due to BA and a small focus of moderately differentiated HCC.
- The patient underwent deceased donor liver transplantation at 10 months of age.
Findings:
- The resected native liver showed established cirrhosis secondary to BA with microscopic vascular invasion in the HCC.
- Postoperative recovery was uneventful.
- The patient remains well with no recurrence at 4 months post-transplant.
Implications:
- This case represents one of the youngest documented instances of HCC in a patient with BA.
- It underscores the need for vigilance in screening for HCC in infants diagnosed with BA.
- Liver transplantation is a viable treatment option for this rare but severe complication.
Abstract:
We present a case of a 10-month-old boy with BA who developed HCC and was treated with liver transplantation. A four-month-old boy was referred to our institution because of persistent jaundice, hepatomegaly, and coagulopathy. He had been treated for the diagnosis of neonatal hepatitis at an outside hospital. He was evaluated and was accepted as a liver transplant candidate, and was subsequently transplanted with a deceased donor liver allograft at the age of 10 months. His native liver showed established cirrhosis because of BA with one focus of moderately differentiated HCC, measuring 0.7 cm in a diameter with microscopic vascular invasion in pathological study. The postoperative course was uneventful, and he is well without recurrence four months after liver transplantation. The occurrence of HCC in a child under one yr old is extremely rare, and only three cases are reported so far including our case.