title: Hepatocellular carcinoma in the youth. A comparative analysis with hepatocellular carcinoma in adulthood.
abstract: OBJECTIVE
  Hepatocellular carcinoma (HCC) is a very rare disease among young individuals. Epidemiological, clinical and histopathological features of this malignancy in the youth have not been thoroughly studied.
  
  
  METHODS
  A review of the clinical files of patients with HCC younger than 40 years of age, who were treated between May 1990 and July 2002, was performed.
  
  
  RESULTS
  Seventeen patients were included for analysis; nine were female and eight male. The mean age at diagnosis was 24 years (range 12-39 years). Abdominal pain was the main symptom, followed by vomiting and nausea. Enlargement of the liver was observed in 11 patients (65%). In seven patients (41%), an etiological factor was not found. Five of these cases were of the fibrolamellar variant (29%). Only four patients were resected (23%) two of which belonged to the fibrolamellar type. Three patients (18%) are still alive after 64.9 months of follow-up.
  
  
  CONCLUSIONS
  HCC is a very uncommon disease in the youth and affects similarly both genders. It is discovered at an advanced stage. Hepatitis B and C are uncommon etiological factors. The frequency of fibrolamellar carcinoma is higher in this age group. Though resection is more feasible, the overall survival rates remain low.
authors.affiliation: Department of Gastroenterology, Instituto Nacional de Cancerologia (INCan), Mexico City, Mexico.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Hernández-Castillo
authors.forename: Ricardo
authors.initials: R
authors.lastname: Mondragón-Sánchez
authors.forename: Ana Lilia
authors.initials: AL
authors.lastname: Garduno-Lopez
authors.forename: Elvira
authors.initials: E
authors.lastname: Gómez-Gómez
authors.forename: Juan M
authors.initials: JM
authors.lastname: Ruiz-Molina
authors.forename: Luis F
authors.initials: LF
authors.lastname: Oñate-Ocaña
authors.forename: Rigoberto
authors.initials: R
authors.lastname: Bernal-Maldonado
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D002648:Child; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D015994:Incidence; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies