[Hepatocellular carcinoma as a rare cause of excessive rise in alpha-fetoprotein in pregnancy].
OBJECTIVE
Elevation of alphafetoprotein in pregnancy warrants a thorough diagnostic workup. In most cases, no pathologic result in the fetus will be obtained.


METHODS
A case report is presented on a hepatocellular carcinoma (HCC) during pregnancy, in which a massive increase of alpha-fetoprotein (AFP) was found during a routine screening for neural tube defects in the 17th week of gestation. The amniocentesis revealed a normal AFP value in the amniotic fluid. Liver sonography in the 21st week of gestation showed a 5 cm tumor, which was interpreted as nodular focal hyperplasia. In the control sonography in the 32nd week of gestation, there was a growth to 12 cm. The subsequently performed magnetic resonance imaging (MRI) and fine needle aspiration led to the diagnosis of a HCC. Delivery was performed in the 34th week of gestation by cesarean section followed by surgical therapy of the HCC.


CONCLUSIONS
Unexplained cases of alphafetoproteinelevation in pregnancy can be caused by maternal disease and should prompt a directed amnamnestic and diagnostic search for maternal causes. Nuclear magnetic resonance beyond the first trimester of gestation can help to clarify the diagnosis in liver tumors.
Entezami
M
M
Frauenklinik, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin. Entezami@ukbf.fu-berlin.de
Hardt
W
W
Ebert
A
A
Runkel
S
S
Becker
R
R
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D002585:Cesarean Section; D003937:Diagnosis, Differential; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000097:blood / Q000175:diagnosis; D006498:Hepatectomy; D006801:Humans; D007231:Infant, Newborn; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D009436:Neural Tube Defects / Q000097:blood / Q000175:diagnosis; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D016216:Ultrasonography, Prenatal; D000509:alpha-Fetoproteins / Q000378:metabolism*
D000509:alpha-Fetoproteins
Hepatozelluläres Karzinom als seltene Ursache einer exzessiven Erhöhung des Alpha-Fetoprotein in der Schwangerschaft.