Hepatocellular carcinoma in youth: a comparative analysis with hepatocarcinoma in adults
Hepatocellular carcinoma (HCC) is a very rare disease among young individuals. Epidemiological, clinical, and histopathological features of this malignancy in youth have not been thoroughly studied. A review of clinical files of patients with HCC < 40 years of age treated between May 1990 and July 2002 was performed. Seventeen patients were included for analysis, nine were female and eight, male. Mean age at diagnosis was 24 years (range 12-39 years). Abdominal pain was the main symptom, followed by vomiting and nausea. Enlargement of liver was observed in 11 patients (65%). In seven patients (41%), etiologic factor was not found. Five of these cases were of fibrolamellar variant (29%). Only four patients were resected (23%) two of whom belonged to fibrolamellar type. Three patients (18%) are still alive after 64.9 months of follow-up. HCC is a very uncommon disease in youth and affects similarly both genders. It is discovered at advanced stage. Hepatitis B and C are uncommon etiologic factors. Frequency of fibrolamellar carcinoma is higher in this age group. Although resection is more feasible, overall survival rates remain low.