Successful Liver Transplantation for Hyperammonemic Fibrolamellar Hepatocellular Carcinoma.
Fibrolamellar hepatocellular carcinoma is a rare hepatocellular tumor usually arising in noninfected and noncirrhotic livers. Only 2 cases accompanied by hyperammonemia due to intrahepatic shunting have been reported. A 23-year-old white woman presented with a 2-week history of nausea, vomiting, generalized weakness, and intermittent right upper quadrant pain. Abdominal computerized tomography revealed a 13 x 9-cm hepatic mass. Core-needle biopsy revealed fibrolamellar hepatocellular carcinoma. She presented with coma due to hyperammonemia levels (peak at 437 mcg/dL) but without metastatic disease. She was urgently transplanted, started on daily sorafenib 8 weeks after transplantation, and was free of disease at 1 year after transplantation.
Department of Liver Transplantation, Tampa General Hospital, University of South Florida, Morsani College of Medicine, Tampa, FL.
Angel E
AE
Alsina
Department of Liver Transplantation, Tampa General Hospital, University of South Florida, Morsani College of Medicine, Tampa, FL.
Edson
E
Franco
Department of Liver Transplantation, Tampa General Hospital, University of South Florida, Morsani College of Medicine, Tampa, FL.
Ahmad
A
Nakshabandi
Department of Hepatology, Tampa General Hospital, University of South Florida, Morsani College of Medicine, Tampa, FL.
Christopher
C
Albers
Department of Hepatology, Tampa General Hospital, University of South Florida, Morsani College of Medicine, Tampa, FL.
Nyingi
N
Kemmer
Department of Medicine, University of South Alabama, Mobile, AL.
Andrew C
AC
Berry
Department of Pathology, Tampa General Hospital, University of South Florida, Morsani College of Medicine, Tampa, FL.
Jon
J
Finan