Hepatocellular carcinoma in pregnancy with unusual presentations

ABSTRACT

Hepatocellular carcinoma [HCC] is very rare during pregnancy and has a worse prognosis in pregnant women compared to those who are not pregnant. We present a case of HCC in a 41- year-old pregnant patient who was referred to our academic hospital. The patient presented with chief complaints of abdominal pain, jaundice, ede-ma and hypertension. Laboratory results were notable for elevated liver enzymes and features of microangiopathic hemolytic anemia with normal alpha fetoprotein [AFP] and elevated cancer antigen 125 [CA125]. At laparotomy for termination of pregnancy, multiple massive lesions were detected in the liver. Histologic evaluation showed features of HCC. HCC must be included in the differential diagnosis of any pregnant patient who presents with elevated liver enzymes and hemolysis.