Fibrolameller hepatosellüler kanser ve gebelik ilişkisi: Olgu sunumu

Fibrolamellar hepatocellular carcinoma is a rare and distinct histological variant of hepatocellular cancer. Fibrolamellar hepatocellular carcinoma differs from hepatocellular cancer with a non-cirrhotic background, a favorable clinical presentation and a better prognosis. As a rare tumor of the liver, there is scarce data on the relationship between pregnancy and fibrolamellar carcinoma. In this case report, we present a 30-year-old woman who admitted to our department with complaints of abdominal pain, weight loss and a previous history of pregnancy. The patient had a history of medical abortus due to uncontrollable vaginal bleeding in the 6th week of pregnancy. A month later, physical examination showed liver enlargement without any abnormalities in the initial investigation. Virological markers of hepatitis B and C infections were found to be negative. Biochemical parameters and alpha fetoprotein were all in normal range except for substantial elevation of serum lactate dehydrogenase and mildly elevated levels of aminotransferases. Abdominal tomography revealed liver enlargement with a mass measuring approximately 8x9 cm in the right lobe. Histopathological findings of the liver specimen were compatible with fibrolamellar hepatocellular carcinoma. The patient was accepted to be in advanced stage according to the rapid progression of the tumor and lymph node metastasis. She was considered as inoperable and only palliative treatment could be instituted due to the patientas unwillingness. In conclusion, fibrolamellar hepatocellular carcinoma should be considered when a liver mass with or without vaginal bleeding is detected in a pregnant patient. Fibrolamellar hepatocellular carcinoma may have adverse effects on the pregnancy outcome and may have a rapid course in pregnancy.