HEPATOCELLULAR-CARCINOMA FOLLOWING NEONATAL HEPATITIS

Hepatocellular carcinoma is an uncommon malignancy in young children a ssociated with a variety of congenital and acquired conditions. It has been generally held that idiopathic neonatal hepatitis is not an ante cedent of hepatocellular neoplasia in childhood. We report a 28-month- old girl in whom a diagnosis of neonatal giant cell hepatitis was conf irmed by liver biopsy at 4 months of age who was followed up with seri al liver biopsies. Hepatitis B and C virus infection and metabolic abn ormalities had been excluded by appropriate testing. There was no hist ory of parenteral nutrition. The morphologic criteria for a diagnosis of cirrhosis were satisfied in a liver biopsy undertaken at 23 months of age. At 28 months a laparotomy was performed because of continuing jaundice and the development of an abdominal mass. Biopsy of the mass revealed a hepatocellular carcinoma. Ploidy studies showed an aneuploi d tumor and a hyperdiploid karyotype was confirmed by chromosomal anal ysis. This case demonstrates by sequential biopsy the progression from neonatal hepatitis to cirrhosis and hepatocellular carcinoma in a you ng child.