Hepatocellular Carcinoma: An Unusual Presentation of this Rare Clinical Entity in Children

Detalhes bibliográficos
Autor(a) principal: Martins, Marta
Data de Publicação: 2021
Outros Autores: Cardosa, Maria Filomena, Calhau, Paulo, Caldas, Gabriela, Alves, Rui
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://ojs.pjp.spp.pt/article/view/20462
Resumo: Malignant hepatic tumors are rare in children and hepatocellular carcinomas only represent 20% of cases. A previously healthy 10-year old male was admitted for sudden abdominal pain. Ultrasound imaging showed an ileo-ileal intussusception with spontaneous resolution, but in face of worsening pain, fever and a palpable epigastric mass, an MRI was done, showing a liver lesion. Laboratory exams presented elevated liver enzymes and C-reactive protein so a liver abscess was considered and treated with metronidazole plus ceftriaxone. All the microbiology tests were negative so as tumoral markers. Despite a clinical and laboratory improvement, the lesion persisted on imaging. A liver biopsy confirmed a hepatocellular carcinoma and the patient was submitted to surgical resection and chemotherapy. Contrarily to adults in whom most cases are secondary to chronic liver disease, children may not have risk factors for the disease, which makes it harder to do a prompt diagnosis.
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spelling Hepatocellular Carcinoma: An Unusual Presentation of this Rare Clinical Entity in ChildrenCarcinoma hepatocelular: uma entidade rara em idade pediátricaCase reportsMalignant hepatic tumors are rare in children and hepatocellular carcinomas only represent 20% of cases. A previously healthy 10-year old male was admitted for sudden abdominal pain. Ultrasound imaging showed an ileo-ileal intussusception with spontaneous resolution, but in face of worsening pain, fever and a palpable epigastric mass, an MRI was done, showing a liver lesion. Laboratory exams presented elevated liver enzymes and C-reactive protein so a liver abscess was considered and treated with metronidazole plus ceftriaxone. All the microbiology tests were negative so as tumoral markers. Despite a clinical and laboratory improvement, the lesion persisted on imaging. A liver biopsy confirmed a hepatocellular carcinoma and the patient was submitted to surgical resection and chemotherapy. Contrarily to adults in whom most cases are secondary to chronic liver disease, children may not have risk factors for the disease, which makes it harder to do a prompt diagnosis.As neoplasias hepáticas malignas são raras em idade pediátrica e o carcinoma hepatocelular representa apenas 20% dos casos. Adolescente do sexo masculino, 10 anos, previamente saudável, admitido por dor abdominal súbita. Ecografia abdominal mostrou invaginação íleo-ileal com resolução espontânea, mas perante agravamento da dor, febre e massa epigástrica palpável fez ressonância magnética, que evidenciou uma lesão hepática. Analiticamente apresentava aumento das enzimas hepáticas e proteína C reativa pelo que foi admitido um abcesso hepático e foi medicado com metronidazol e ceftriaxone. Exames microbiológicos e marcadores tumorais negativos. Apesar de melhoria clínica e laboratorial, a lesão persistiu em exame de imagem. A biópsia hepática confirmou um carcinoma hepatocelular e o doente foi submetido a ressecção cirúrgica e quimioterapia. Ao contrário dos adultos, em que a maioria dos casos são secundários a doença hepática crónica, em crianças podem não existir fatores de risco identificados, o que pode dificultar o diagnóstico atempado.Sociedade Portuguesa de Pediatria2021-04-15info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://ojs.pjp.spp.pt/article/view/20462eng2184-44532184-3333Martins, MartaCardosa, Maria FilomenaCalhau, PauloCaldas, GabrielaAlves, Ruiinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-08-03T02:58:10Zoai:ojs.revistas.rcaap.pt:article/20462Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:25:35.495383Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Hepatocellular Carcinoma: An Unusual Presentation of this Rare Clinical Entity in Children
Carcinoma hepatocelular: uma entidade rara em idade pediátrica
title Hepatocellular Carcinoma: An Unusual Presentation of this Rare Clinical Entity in Children
spellingShingle Hepatocellular Carcinoma: An Unusual Presentation of this Rare Clinical Entity in Children
Martins, Marta
Case reports
title_short Hepatocellular Carcinoma: An Unusual Presentation of this Rare Clinical Entity in Children
title_full Hepatocellular Carcinoma: An Unusual Presentation of this Rare Clinical Entity in Children
title_fullStr Hepatocellular Carcinoma: An Unusual Presentation of this Rare Clinical Entity in Children
title_full_unstemmed Hepatocellular Carcinoma: An Unusual Presentation of this Rare Clinical Entity in Children
title_sort Hepatocellular Carcinoma: An Unusual Presentation of this Rare Clinical Entity in Children
author Martins, Marta
author_facet Martins, Marta
Cardosa, Maria Filomena
Calhau, Paulo
Caldas, Gabriela
Alves, Rui
author_role author
author2 Cardosa, Maria Filomena
Calhau, Paulo
Caldas, Gabriela
Alves, Rui
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Martins, Marta
Cardosa, Maria Filomena
Calhau, Paulo
Caldas, Gabriela
Alves, Rui
dc.subject.por.fl_str_mv Case reports
topic Case reports
description Malignant hepatic tumors are rare in children and hepatocellular carcinomas only represent 20% of cases. A previously healthy 10-year old male was admitted for sudden abdominal pain. Ultrasound imaging showed an ileo-ileal intussusception with spontaneous resolution, but in face of worsening pain, fever and a palpable epigastric mass, an MRI was done, showing a liver lesion. Laboratory exams presented elevated liver enzymes and C-reactive protein so a liver abscess was considered and treated with metronidazole plus ceftriaxone. All the microbiology tests were negative so as tumoral markers. Despite a clinical and laboratory improvement, the lesion persisted on imaging. A liver biopsy confirmed a hepatocellular carcinoma and the patient was submitted to surgical resection and chemotherapy. Contrarily to adults in whom most cases are secondary to chronic liver disease, children may not have risk factors for the disease, which makes it harder to do a prompt diagnosis.
publishDate 2021
dc.date.none.fl_str_mv 2021-04-15
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://ojs.pjp.spp.pt/article/view/20462
url https://ojs.pjp.spp.pt/article/view/20462
dc.language.iso.fl_str_mv eng
language eng
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2184-3333
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eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Pediatria
publisher.none.fl_str_mv Sociedade Portuguesa de Pediatria
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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