HBs 抗原陽性小児肝細胞癌の1例と本邦報告例の集計

抄録

A 11-year-old boy having adult type hepatocellular carcinoma associated with positive hepatitis B surface antigen was reported. On admission his upper abdomen was protruded and hard mass was palpated. Laboratory examination revealed elevated serum AFP, 589ng/ml.; cholesterol, 730mg/dl.; GOT, 168U/ml., GPT, 185U/ml. Serum HBs antigen was positive, but HBe antigen was negative. The patient was suspected to have been infected by maternal vertical transmission. In radiographic finding CT showed multiple low density area, and angiography revealed hypervascular tumorous lesion feeded by right and left hepatic artery. Tumor resection was impossible, and limited only to biopsy, so infusion chemotherapy of 5-FU and MMC from proper hepatic artery was performed. There was no improvement, and he died of tumor progression on the 51st hospital day. Postmortem examination of the liver revealed posthepatitic cirrhotic hepatocellular carcinoma complicated with bleeding, necrosis, and fatty degeneration. Review of the Japanese literature disclosed 10 other cases of HBs antigen positive hepatocellular carcinoma in children. All the cases were male, and HBs antigen and HBe antibody were postive, but HBs antibody and HBe antigen were negative. In laboratory finding serum AFP was elevated in all, but the value of cholesterol was not so high and in nearly half the cases below 300mg/dl. In radiographic finding CT showed multiple low density area, and angiography revealed hypervascular tumorous circulation.