A 6-year-old Boy Having Hepatocellular Carcinoma Associated with Hepatitis B Surface Antigenemia

Hepatocellular carcinoma associated with hepatitis B virus (HBV) infection occurring in a boy who was 6 years 2 months old is reported. The patient is thought to have been infected with HBV by exchange blood transfusion (horizontal infection) in the neonatal period. Jaundice appeared eight months after birth. He was subsequently treated and follow-up with a diagnosis of hepatitis B surface (HBs) antigen (Ag)-positive chronic persistent hepatitis. His mother and other family members were HBsAg-negative. Postmortem examination revealed a multinodular growth of hepatocellular carcinoma of trabecular and solid pattern, mainly of the right lobe, complicated with mild fibrosis of the liver. Numerous HBsAg-positive hepatocytes demonstrated by orcein staining and the indirect immunoperoxidase method were present in the noncancerous area. This hepatocellular carcinoma is considered to have occurred within six years two months after HBV infection and not to have been associated with liver cirrhosis. The present case may be valuable for assessing the oncogenic properties of HBV and the incubation period of HBV infection before it develops into hepatocellular carcinoma.