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Chinese Journal of Hepatic Surgery(Electronic Edition) ›› 2013, Vol. 02 ›› Issue (04): 245-248. doi: 10.3877/cma.j.issn.2095-3232.2013.04.009

Special Issue:

• Clinical Research • Previous Articles     Next Articles

Hepatocellular carcinoma in pregnancy: report of 9 cases

Han-qing CHEN1, Su-hua ZOU1, Jian-bo YANG1, Li-nan XU1,()   

  1. 1. Department of Obstetrics and Gynecology, the First Affiliated Hospital of Sun Yat-sen Uni-versity, Guangzhou 510080, China
  • Received:2013-04-17 Online:2013-08-10 Published:2013-08-10
  • Contact: Li-nan XU
  • About author:
    Corresponding author:XU Li-nan,Email:

Abstract:

Objective

To discuss the clinical characteristics, diagnosis, treatment and prognosis of patients with hepatocellular carcinoma(HCC) in pregnancy.

Methods

Clinical data of 9 patients with HCC in pregnancy in Department of Obstetrics and Gynecology of the First Affiliated Hospital of Sun Yat-sen University from January 2003 to January 2013 were analyzed retrospectively. The patients' age was 18-37 years old with the median age of 28 years old. The patients were diagnosed as HCC at 18-37 gestational weeks, and they delivered at 18+5-38 gestational weeks with an average of 33+1 weeks. Eight cases had a history of hepatitis B before pregnancy. Five cases suffered persistent upper or right upper abdominal dull pain, 1 case lower abdominal dull pain, 1 case nausea and vomiting, and 1 cases nausea and bloating. The level of alpha-fetoprotein (AFP) was 106-58 433 μg/L and the diameter of liver tumor was 7-21 cm. Hospital-wide consultation was hold after various examinations had been completed. The treatment plan was jointly developed by Department of Obstetrics and Gynecology, Hepatobiliary Surgery and Anesthesiology. The informed consents of all patients were obtained and the ethical committee approval was received. Caesarean section was performed in 8 patients and induced labour in 1 case. Two cases underwent segmental hepatectomy 1-2 weeks after caesarean section, of which 1 case received 3 periods of chemotherapy following the operation, while the other one received no chemotherapy. One case only received 3 periods of chemotherapy after caesarean section. And the other 6 cases abandoned treatment.

Results

Eight cases delivered healthy babies by cesarean section. Two cases who underwent segmental hepatectomy had survived for 1 year and 4 months respectively till the paper submission day. The case who received single chemotherapy died of systemic multiple metastasis of HCC within 6 months after delivery. The other 6 cases who abandoned treatment died of hemorrhage of HCC within 3 months after delivery.

Conclusions

Patients with HCC in pregnancy are lack of specific clinical manifestations, and most are diagnosed at the middle or advanced stage. The treatments are mainly surgery and chemotherapy and the prognosis is poor. Early detection and timely treatment can help to improve the prognosis.

Key words: Pregnancy, Parturition, Carcinoma, hepatocellular, Hepatectomy, Prognosis, Hepatitis B virus, Alpha-fetoproteins

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