Hepatocellular carcinoma following neonatal hepatitis.
Hepatocellular carcinoma is an uncommon malignancy in young children associated with a variety of congenital and acquired conditions. It has been generally held that idiopathic neonatal hepatitis is not an antecedent of hepatocellular neoplasia in childhood. We report a 28-month-old girl in whom a diagnosis of neonatal giant cell hepatitis was confirmed by liver biopsy at 4 months of age who was followed up with serial liver biopsies. Hepatitis B and C virus infection and metabolic abnormalities had been excluded by appropriate testing. There was no history of parenteral nutrition. The morphologic criteria for a diagnosis of cirrhosis were satisfied in a liver biopsy undertaken at 23 months of age. At 28 months a laparotomy was performed because of continuing jaundice and the development of an abdominal mass. Biopsy of the mass revealed a hepatocellular carcinoma. Ploidy studies showed an aneuploid tumor and a hyperdiploid karyotype was confirmed by chromosomal analysis. This case demonstrates by sequential biopsy the progression from neonatal hepatitis to cirrhosis and hepatocellular carcinoma in a young child.
Moore
L
L
Department of Histopathology, Women's and Children's Hospital, Adelaide Children's Hospital Division, North Adelaide, South Australia.
Bourne
A J
AJ
Moore
D J
DJ
Preston
H
H
Byard
R W
RW
D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D002675:Child, Preschool; D017809:Fatal Outcome; D005260:Female; D005434:Flow Cytometry; D015726:Giant Cells / Q000473:pathology; D006505:Hepatitis / Q000150:complications* / Q000151:congenital* / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000150:complications / Q000473:pathology; D008103:Liver Cirrhosis / Q000473:pathology; D008113:Liver Neoplasms / Q000209:etiology*