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Title
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Pediatric fibrolamellar hepatocellular carcinoma: case report and review of the literature
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Author
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Abstract
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| Background: A 13-year-old boy presented with acute abdominal pain in the right upper quadrant without previous trauma. Abdominal ultrasound (US) revealed a mass in the right liver lobe with free intraperitoneal fluid, suggestive for hemoperitoneum. Magnetic resonance imaging confirmed a subcapsular lesion (5.7 x 4.6 x 4.1 cm), suggestive for fibrolamellar hepatocellular carcinoma (FL-HCC). Positron emission tomography-computed tomography revealed mild to moderate fluorodeoxyglucose (FDG) avidity, with no other FDG avid lesions. Hepatic tumor markers were negative. Case report: An elective right hepatectomy with cholecystectomy and hilar lymph node resection was performed. Results: Histology showed a central fibrous scar and confirmed a FL-HCC (pT1bN0M0). The resected lymph nodes were tumor-free. Treatment of FL-HCC should consist of complete tumor resection with concurrent lymph node resection +/- orthotopic liver transplantation. Long-term follow-up is advised. A follow-up interval of 3-4 months in the first 2 years after surgical resection can be justified as FL-HCC have a high recurrence rate of more than 50% within 10-33 months. Conclusions: Malignancy can be a rare cause of abdominal pain in pediatric patients. An abdominal US is essential to prevent misdiagnosis. Treatment of FL-HCC should consist of R0 tumor resection with concurrent lymphadenectomy +/- orthotopic liver transplantation. |
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Language
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English
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Source (journal)
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Acta chirurgica Belgica. - Brussel, 1946 - 1996
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Publication
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Brussels
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Acta medical belgica
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2019
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ISSN
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0001-5458
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DOI
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10.1080/00015458.2019.1660060
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Volume/pages
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7 p.
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ISI
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000485123800001
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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