Hepatocellular carcinoma in pregnancy

Garko, Sani B; David, O S; Mohammed, Tasiu; Isah, Muktar; Bakari, AG; Oguntayo, Adekunle O; Shehu, Mohammed Sani; Aminu, Sirajo Mohammed

doi:10.4103/1596-3519.59588

Cited by 8 publications

(3 citation statements)

References 5 publications

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“…Estrogen is thought to trigger hepatocyte mitosis, hypervascularization, free radical formation, reactivate HBV, and reduce humoral immunity [ 6 , 23 ]. HCC is generally asymptomatic in early pregnancy, but right upper quadrant pain, palpable mass, weight loss, and hepatomegaly are reported as common complaints in reported cases [ 24 , 25 ]. In this case, shortness of breath due to compression of the thoracic cavity and abdominal pain were the main clinical symptoms complained.…”

Section: Discussionmentioning

confidence: 99%

Co-incidence of COVID-19 and hepatocellular carcinoma during pregnancy: Double punches to disease severity and mortality?

Abubakar,

Yusuf,

Firdausa

et al. 2023

Narra J

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Hepatocellular carcinoma (HCC), a considerable leading cause of cancer-related deaths worldwide, is the most common primary liver cancer with poor prognosis and outcome. Many advances in prevention, screening, and new technologies in diagnostics and therapy have been achieved, but its incidence and mortality remain increasing. Co-infection of another viral disease in HCC patients with pregnancy might exacerbate the condition and double the mortality rate. The aim of this case report was to describe the co-infection of coronavirus disease 2019 (COVID-19) in an HCC patient during pregnancy. A 26-year-old woman with 16–17weeks of gestation was admitted to Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia with shortness of breath. The patient also reported that the abdomen expanded rapidly in the last three weeks, followed by severe pain and collateral vein appearance. Laboratory findings revealed anemia, leukocytosis, HBsAg reactive, hypoalbuminemia, hyperbilirubinemia, elevated liver enzymes, increased alpha-fetoprotein (AFP), and cancer antigen 125 (CA-125). Ultrasonography indicated gestation with a single fetus, an enlarged liver with a 9.9 x 9.4 cm nodule, and massive ascites. The patient was also RT-PCR-confirmed COVID-19. On day 8 of hospitalization, the patient suddenly reported severe abdominal pain. Ultrasonography revealed fetal distress immediately followed by fetal death. Adequate management of cancer pain, continuous evacuation of ascites, and other supportive care could not save the patient who died on the day 17 of hospitalization. In this case, we found no proof that the patient experienced cirrhosis prior to HCC. Pregnancy through hormonal alteration is thought to be the aggravating factor that accelerates the progression of pre-existing liver disease into carcinoma and infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) worsened the outcome in this patient.

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Section: Discussionmentioning

confidence: 99%

Co-incidence of COVID-19 and hepatocellular carcinoma during pregnancy: Double punches to disease severity and mortality?

Abubakar,

Yusuf,

Firdausa

et al. 2023

Narra J

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“…Several early reports suggested that the adverse influence of pregnancy for the development of PLC was probably due to an alteration of the hormonal milieu[ 13 , 14 ]. In contrast, other recent papers attributed the consequence to delayed diagnosis[ 11 , 15 ]. However, the latest cohort analysis needs further interpretation, as most of the published articles were case reports, with the largest including 48 cases published in 2011[ 12 , 16 ].…”

Section: Introductionmentioning

confidence: 89%

Do peripartum and postmenopausal women with primary liver cancer have a worse prognosis? A nationwide cohort in Taiwan

Tseng¹,

Lin²,

Lai³

et al. 2021

WJH

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BACKGROUND While primary liver cancer (PLC) is one of the most common cancers around the world, few large-scale population-based studies have been reported that evaluated the clinical survival outcomes among peripartum and postmenopausal women with PLC. AIM To investigate whether peripartum and postmenopausal women with PLC have lower overall survival rates compared with women who were not peripartum and postmenopausal. METHODS The Taiwan National Health Insurance claims data from 2000 to 2012 was used for this propensity-score-matched study. A cohort of 40 peripartum women with PLC and a reference cohort of 160 women without peripartum were enrolled. In the women with PLC with/without menopause study, a study cohort of 10752 menopausal females with PLC and a comparison cohort of 2688 women without menopause were enrolled. RESULTS Patients with peripartum PLC had a non-significant risk of death compared with the non-peripartum cohort [adjusted hazard ratios (aHR) = 1.40, 95% confidence intervals (CI): 0.89-2.20, P = 0.149]. The survival rate at different follow-up durations between peripartum PLC patients and those in the non-peripartum cohort showed a non-significant difference. Patients who were diagnosed with PLC younger than 50 years old (without menopause) had a significant lower risk of death compared with patients diagnosed with PLC at or older than 50 years (postmenopausal) (aHR = 0.64, 95%CI: 0.61-0.68, P < 0.001). The survival rate of women < 50 years with PLC was significantly higher than older women with PLC when followed for 0.5 (72.44% vs 64.16%), 1 (60.57% vs 51.66%), 3 (42.92% vs 31.28%), and 5 year(s) (37.02% vs 21.83%), respectively ( P < 0.001). CONCLUSION Peripartum females with PLC have no difference in survival rates compared with those patients without peripartum. Menopausal females with PLC have worse survival rates compared with those patients without menopause.

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“…On the other hand, in the type B, the tumor has a slow growth and the hypoglycemia is present throughout the course of the disease; our patient presented this type of hypoglycemia and had a good response to diet and glucose infusion without managing the underlying disease, which is HCC. 8 In a study conducted in Korea, 9 it was observed that the overall survival of pregnant women diagnosed with HCC diagnosis was of 18 months and the prognosis of the babies was: 11% of intrauterine death, 4,3% of deaths at the end of pregnancy, most of the reported cases 10,11 where the evolution for both mother and fetus was torpid, have culminated in death. Nevertheless, our patient, despite of the huge tumor size, managed to survive as did her newborn child.…”

Section: Figure 2 Coronal Section Shows Severe Hepatomegaly Secondary To the Presence Of An Extensive Diffuse Infiltrative Neoformative Lmentioning

confidence: 99%

Hepatocellular Carcinoma in a Woman with 34 Weeks Gestation and Chronic Hepatitis B

Sato-Espinoza¹,

Ferrer²,

Ventura³

2021

Acta gastroenterol. latinoam.

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A 24-year-old pregnant woman arrived at the emergency service at 34 weeks of gestational age with intermittent right upper abdominal pain. An abdominal ultrasound was performed showing signs of hepatopathy with multiple neoformative nodules with mild ascites and fetal biometry confirmed at 34 weeks gestation. During her hospitalization, an emergency caesarean was induced with favorable result in the survival of the mother and the baby.

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Hepatocellular carcinoma in pregnancy

Cited by 8 publications

References 5 publications

Co-incidence of COVID-19 and hepatocellular carcinoma during pregnancy: Double punches to disease severity and mortality?

Co-incidence of COVID-19 and hepatocellular carcinoma during pregnancy: Double punches to disease severity and mortality?

Do peripartum and postmenopausal women with primary liver cancer have a worse prognosis? A nationwide cohort in Taiwan

Hepatocellular Carcinoma in a Woman with 34 Weeks Gestation and Chronic Hepatitis B

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