Hepatitis B-related hepatocellular carcinoma in a 36-year-old pregnant woman: prognosis and management dilemma

• Published in: The Pan African medical journal 2020, Vol.36 (298), p.298-298
• Main Authors: Wembulua, Bruce Shinga, Diallo, Kalilou, Thioubou, Mame Aïsse, Nguma, Jean Didier Bosenge, Manga, Noel Magloire
• Format: Article
• Language: English
• Subjects: Adult; Carcinoma, Hepatocellular - diagnosis; Carcinoma, Hepatocellular - therapy; Carcinoma, Hepatocellular - virology; Case Report; Cesarean Section; chronic hepatitis b infection; Fatal Outcome; Female; Hepatitis B - complications; Hepatitis B - diagnosis; Hepatitis B - therapy; Hepatitis B - transmission; hepatocellular carcinoma; Humans; Infant, Newborn; Liver Failure - diagnosis; Liver Failure - etiology; Liver Failure - therapy; Liver Neoplasms - diagnosis; Liver Neoplasms - therapy; Liver Neoplasms - virology; Maternal Death; Pregnancy; Pregnancy Complications, Infectious - diagnosis; Pregnancy Complications, Infectious - therapy; Pregnancy Complications, Neoplastic - diagnosis; Pregnancy Complications, Neoplastic - therapy; Pregnancy Complications, Neoplastic - virology; Prognosis
• ISSN: 1937-8688; 1937-8688
• DOI: 10.11604/pamj.2020.36.298.22658

Management of chronic hepatitis B infection complicated by hepatocellular carcinoma (HCC) in pregnancy poses a treatment dilemma as the pregnancy accelerates disease progression and narrows the diagnostic tools and therapeutic choices. Studies have reported higher maternal and fetal losses. We share our experience with a 36-year-old pregnant woman who presented at 35 weeks' gestation with a large painful nodular liver and significant weight loss. She tested HBsAg-positive and had both clinical and laboratory features of severe liver decompensation. The abdominal ultrasound rightly described HCC on a cirrhotic background. The fetus was delivered by cesarean section but the mother died soon after.