DOI: 10.1097/01.mpg.0000189342.38634.ac
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PMID: 16641583
Issn Print: 0277-2116
Publication Date: 2006/04/01
Chronic Diarrhea as First Manifestation of Liver Cirrhosis and Hepatocarcinoma in a Teenager: A Case Report and Review of the Literature
Carlos Robles-Medranda; Hannah P. Lukashok; Paula Novais; Beatriz Biccas; Homero Fogaça
Excerpt
Hepatocellular carcinoma (HCC) is rare in children, accounting for approximately 0.5% of all pediatric malignances (1). It is the second most common hepatic malignancy in children after hepatoblastoma, with an incidence of 0.5% to 1.0% cases per million (2). HCC is closely associated with chronic hepatitis B virus (HBV) infection and occurs mainly in adults between 40 and 60years of age (3-5). However, HCC may develop in children who live in hyperendemic areas as a consequence of vertical or horizontal HBV transmission (6). With the introduction of HBV vaccination programs, the incidence of HCC has declined markedly in many countries (3,5,7). In Brazil, the vaccination program began in 1990. Thus, there is still a sizable number of people with chronic HBV infection.
The symptoms of HCC are usually those of chronic liver disease and are generally nonspecific (8). Chronic diarrhea has been described as one manifestation of liver cirrhosis and HCC. Its pathogenesis is poorly understood and probably multifactorial. This report describes a patient with cirrhosis and HCC who presented with chronic diarrhea. Possible mechanisms leading to diarrhea are discussed.
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