Two Cases of the Hepatocellular Cancinoma in Pregnancy

ABSTRACT

Hepatocellular carcinoma (HCC) during pregnancy is a rare event and reports are isolated and highly scattered. HCC during pregnancy carries a poor prognosis because of difficulty in diagnosis due to the fetus. The impact of pregnancy on the prognosis of patients with HCC and the risk factors of developing HCC during pregnancy remains controversial. At present, the screening of maternal serum alpha-fetoprotein(AFP) in the second trimester of pregnancy is a standard procedure for detection of fetal malformation. An elevated maternal serum AFP level may not always be of fetal origin and some maternal diseases could present an elevated maternal serum AFP. The ultrasonography for abdomen has been accepted as a simple and safe method for this group. We have experienced two cases of HCC during pregnancy over the last 5 years. One was diagnosed with a palpble abdominal mass which was revealed to be HCC at 12 weeks of pregnancy and died 2 months after the diagnosis without treatmemt. The second was incidentally found to have abnormal serum AFP at 17 weeks of pregnancy and underwent the extended right hepatic lobectomy without complication. We suggest that careful physical examination and abdominal ultrasonography seems to be the best screening tools for early diagnosis of HCC in pregnancies with high serum AFP level.