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A 6-year-old boy having hepatocellular carcinoma associated with hepatitis B surface antigenemia
Insights
Hepatocellular carcinoma (HCC) developed in a young boy within six years of hepatitis B virus (HBV) infection, likely acquired horizontally. This case highlights HBV
Area of Science:
- Hepatology
- Oncology
- Virology
Background:
- Hepatocellular carcinoma (HCC) is a significant global health concern, often linked to chronic viral infections.
- Hepatitis B virus (HBV) infection is a primary risk factor for HCC development.
- Early-onset HCC in children is rare but crucial for understanding disease progression.
Observation:
- A case report of a 6-year-old boy with hepatocellular carcinoma (HCC) associated with hepatitis B virus (HBV) infection.
- The patient experienced horizontal HBV transmission during the neonatal period via blood transfusion, confirmed by HBsAg positivity.
- Postmortem examination revealed multinodular HCC with numerous HBsAg-positive hepatocytes in noncancerous liver tissue.
Findings:
- HCC was diagnosed within 6 years and 2 months of documented HBV infection.
- The tumor occurred without evidence of underlying liver cirrhosis.
- Hepatitis B surface antigen (HBsAg) was detected in hepatocytes, indicating active viral replication.
Implications:
- This case provides valuable insights into the oncogenic potential of HBV in pediatric populations.
- It suggests a relatively short incubation period for HCC development following HBV infection in some individuals.
- Understanding early-onset HCC in HBV-infected children is critical for assessing long-term risks and potential interventions.
Abstract:
Hepatocellular carcinoma associated with hepatitis B virus (HBV) infection occurring in a boy who was 6 years 2 months old is reported. The patient is thought to have been infected with HBV by exchange blood transfusion (horizontal infection) in the neonatal period. Jaundice appeared eight months after birth. He was subsequently treated and follow-up with a diagnosis of hepatitis B surface (HBs) antigen (Ag)-positive chronic persistent hepatitis. His mother and other family members were HBsAg-negative. Postmortem examination revealed a multinodular growth of hepatocellular carcinoma of trabecular and solid pattern, mainly of the right lobe, complicated with mild fibrosis of the liver. Numerous HBsAg-positive hepatocytes demonstrated by orcein staining and the indirect immunoperoxidase method were present in the noncancerous area. This hepatocellular carcinoma is considered to have occurred within six years two months after HBV infection and not to have been associated with liver cirrhosis. The present case may be valuable for assessing the oncogenic properties of HBV and the incubation period of HBV infection before it develops into hepatocellular carcinoma.