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- W2892536721 abstract "The incidence of hepatocellular carcinoma (HCC) in pregnancy is rare, with less than 50 cases reported in the past sixty years.We describe the case of a 39-year old woman in her second pregnancy, with a diagnosis of HCC, and provide a review of relevant literature. We delineate the management challenges, highlighting the importance of multi-disciplinary care in women with complex medical conditions. A diagnosis of HCC was made incidentally following hepato-splenic-pancreatectomy for a presumed hepatic adenoma in the context of multiple arterio-venous malformations(AVMs) in 2013 on a background of Hereditary Haemorrhagic Telangiectasia (HHT; Osler-Weber-Rendu syndrome). Despite surgical resection and chemo-radiotherapy, recurrent inoperable HCC persisted in conjunction with pulmonary hypertension. An unplanned pregnancy was assessed in the first trimester in the Perinatal Medicine clinic with multi-disciplinary involvement from surgery, hepatology, radiology, cardiology and anaesthetics throughout the pregnancy. This included antenatal serial multi-disciplinary assessment, surveillance Magnetic Resonance Imaging (demonstrating continued tumour growth at 17 and 33 weeks), surveillance echocardiographies and a right cardiac catheterisation. Following spontaneous onset of labour at 33 weeks gestation under epidural anaesthesia, a live female infant delivered spontaneously, with maternal and neonatal survival six months following delivery. The incidence of HCC worldwide is 5.5/10,000 and is associated with liver cirrhosis and hepatitis. In previous cases affecting pregnancy, increased oestrogen and liver vascularity have expedited progression of HCC and deterioration in pregnancy, which was not ultimately evident in our case. It is also implicated with poorer obstetric outcomes, an increased risk of hepatic rupture and shorter median survival than non-pregnant counterparts. Associated conditions such as pulmonary hypertension and HHT have an additional impact on maternal and fetal morbidity and mortality. We outline the first case report of recurrent, inoperable HCC in pregnancy that with dedicated MDT involvement, maternal and fetal outcome can be optimised, with favourable outcomes possible." @default.
- W2892536721 created "2018-10-05" @default.
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- W2892536721 date "2018-10-01" @default.
- W2892536721 modified "2023-10-03" @default.
- W2892536721 title "378. Recurrent hepatocellular carcinoma in pregnancy: A case report and literature review" @default.
- W2892536721 doi "https://doi.org/10.1016/j.preghy.2018.08.413" @default.
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