LIVER CANCER ASSOCIATED WITH HEPATITIS B VIRUS INFECTION IN A CHILD: A CASE REPORT

Karina Pharamita Dewi; Rendi Aji Prihaningtyas; Bagus Setyoboedi; Sjamsul Arief

doi:10.20473/jvhs.V9.I1.2025.64-69

Authors

Karina Pharamita Dewi Department of Child Health, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia https://orcid.org/0009-0005-4330-9571
Rendi Aji Prihaningtyas Department of Child Health, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia https://orcid.org/0000-0002-7582-7892
Bagus Setyoboedi
bagus.setyoboedi@fk.unair.ac.id
Department of Child Health, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia https://orcid.org/0000-0002-3923-6913
Sjamsul Arief Department of Child Health, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia https://orcid.org/0000-0002-6372-2460

Vol. 9 No. 1 (2025): July 2025 | JOURNAL OF VOCATIONAL HEALTH STUDIES

Case Study

31 July 2025

Downloads

PDF

Abstract
How to Cite
Author Biographies
Metrics
References
License

Background: Two-thirds of primary liver tumors in children are malignant. Hepatoblastoma (HBL) accounts for 40-60 percent of pediatric liver tumors and is the most common malignant liver tumor. Hepatocellular Carcinoma (HCC) is the second most common malignancy in children, accounting for approximately 20% of cases. Both malignant liver tumors have similar clinical and imaging features, but different prognosis and treatment. Purpose: This report aims a case of liver cancer related to hepatitis B virus infection in a child. Case analysis: A 15-year-old girl presented with a two-month history of right upper quadrant pain along with abdominal distension, weight loss, back pain, anorexia, nausea, weakness and fatigue for 5 months prior to admission. Physical examination revealed a hard, firm mass with a bumpy surface in the right upper quadrant of the abdomen and splenomegaly. Laboratory test showed an increase in Lactate Dehydrogenase (LDH), Gamma-Glutamyl Transpeptidase (GGT), Alpha Feto Protein (AFP), quantitative Hepatitis B Virus (HBV) DNA, and HBsAg reactive. Abdominal Multi-Slice Computed Tomography (MSCT) revealed malignant solid mass with necrotic component inside, indistinct borders, irregular margins and kissing spleen. Result: The diagnosis of liver cancer in this patient suggested HCC associated with chronic hepatitis B infection. Conclusion: Routine follow-up of all children with chronic hepatitis B infection is crucial because of the risk of developing liver cancer in adolescence and adulthood.

Alemayehu, T., Hailu, D., 2019. Hepatocellular Carcinoma with Vertebral Metastasis in A Child with Hepatitis B Virus Infection: A Case Report. Journal of Medical Case Reports Vol. 13(1), Pp. 158.

Alshareefy, Y., Shen, C.Y., Prekash, R.J., 2023. Exploring The Molecular Pathogenesis, Diagnosis and Treatment of Fibrolamellar Hepatocellular Carcinoma: A State of Art Review of The Current Literature. Pathology, Research and Practice Vol. 248, Pp. 154655.

Borgia, G., Carleo, M.A., Gaeta, G.B., Gentile, I., 2012. Hepatitis B in Pregnancy. World Journal of Gastroenterology Vol. 18(34), Pp. 4677-4683.

Brusset, B., Jacquemin, M., Teyssier, Y., Roth, G.S., Sturm, N., Roustit, M., Bône, A., Ghelfi, J., Costentin, C.E., Decaens, T., 2024. Radiological Diagnosis of Hepatocellular Carcinoma does not Preclude Biopsy before Treatment. JHEP Reports: Innovation in Hepatology Vol. 6(1), Pp.100957.

Camara, M., Tantuoyir, M.M., SeyedAlinaghi, S., Ghiasvand, F., Ahmadinejad, Z., 2023. Prevalence of Hepatitis B Infection in The Gambian Population: A Narrative Review of Recent Developments. Preventive Medicine Reports Vol. 36, Pp. 102401.

Filippo Villa di, D., Navas, M.-C., 2023. Vertical Transmission of Hepatitis B Virus - An Update. Microorganisms Vol. 11(5), Pp. 1140.

Digiacomo, G., Serra, R.P., Turrini, E., Tiri, A., Cavazzoni, A., Alfieri, R., Bertolini, P., 2023. State of The Art and Perspectives in Pediatric Hepatocellular Carcinoma. Biochemical Pharmacology Vol. 207, Pp. 115373.

Du, Z., Yin, S., Liu, B., Zhang, W., Sun, J., Fang, M., Xu, Y., Hua, K., Tu, P., Zhang, G., Ma, Y., Lu, Y., 2023. Metabolomics and Network Analysis Uncovered Profound Inflammation-Associated Alterations in Hepatitis B Virus-Related Cirrhosis Patients with Early Hepatocellular Carcinoma. Heliyon Vol. 9(5), Pp. e16083.

Felden, J. Von, Schulze, K., Krech, T., Ewald, F., Nashan, B., Pantel, K., Lohse, A.W., Riethdorf, S., Wege, H., 2017. Circulating Tumor Cells as Liquid Biomarker for High HCC Recurrence Risk after Curative Liver Resection. Oncotarget Vol. 8(52), Pp. 89978-89987.

Hu, Y., Wu, X., Ye, Y., Ye, L., Han, S., Wang, X., Yu, H., 2022. Liver Histology of Treatment-Naïve Children with Chronic Hepatitis B Virus Infection in Shanghai China. International Journal of Infectious Diseases: IJID: Official Publication of The International Society for Infectious Diseases Vol. 123, Pp. 112-118.

Indolfi, G., Easterbrook, P., Dusheiko, G., Siberry, G., Chang, M.-H., Thorne, C., Bulterys, M., Chan, P.-L., El-Sayed, M.H., Giaquinto, C., Jonas, M.M., Meyers, T., Walsh, N., Wirth, S., Penazzato, M., 2019. Hepatitis B Virus Infection in Children and Adolescents. The Lancet. Gastroenterology & Hepatology Vol. 4(6), Pp. 466-476.

Khanna, R., Verma, S.K., 2018. Pediatric Hepatocellular Carcinoma. World Journal of Gastroenterology Vol. 24(35), Pp. 3980-3999.

Lee, W.M., 1997. Hepatitis B Virus Infection. New England Journal of Medicine Vol. 337(24), Pp. 1733-1745.

Lim, J.K., Nguyen, M.H., Kim, W.R., Gish, R., Perumalswami, P., Jacobson, I.M., 2020. Prevalence of Chronic Hepatitis B Virus Infection in The United States. The American Journal of Gastroenterology Vol. 115(9), Pp. 1429-1438.

Mogul, D.B., Ling, S.C., Murray, K.F., Schwarzenberg, S.J., Rudzinski, E.R., Schwarz, K.B., 2018. Characteristics of Hepatitis B Virus-Associated Hepatocellular Carcinoma in Children: A Multi-Center Study. Journal of Pediatric Gastroenterology and Nutrition Vol. 67(4), Pp. 437-440.

Morais, E., Mason, L., Dever, J., Martin, P., Chen, J.V., Felton, L., Kendrick, S., Theodore, D., Gillespie, I.A., 2023. Clinical Consequences of Hepatitis B Surface Antigen Loss in Chronic Hepatitis B Infection: A Systematic Literature Review and Meta-Analysis. Gastro Hep Advances Vol. 2(7), Pp. 992-1004.

Murawski, M., Weeda, V.B., Maibach, R., Morland, B., Roebuck, D.J., Zimmerman, A., Casanova, M., Perilongo, G., Laithier, V., Kebudi, R., Scopinaro, M.J., Shun, A., Brichard, B., de Camargo, B., Childs, M., Aronson, D.C., Czauderna, P., 2016. Hepatocellular Carcinoma in Children: Does Modified Platinum- and Doxorubicin-Based Chemotherapy Increase Tumor Resectability and Change Outcome? Lessons Learned from the SIOPEL 2 and 3 Studies. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology Vol. 34(10), Pp. 1050-1056.

Pinto, E., Meneghel, P., Farinati, F., Russo, F.P., Pelizzaro, F., Gambato, M., 2024. Efficacy of Immunotherapy in Hepatocellular Carcinoma: Does Liver Disease Etiology Have A Role? Digestive and Liver Disease. Digestive and Liver Disease Vol. 56(4), Pp. 579-588.

Ranganathan, S., Lopez-Terrada, D., Alaggio, R., 2020. Hepatoblastoma and Pediatric Hepatocellular Carcinoma: An Update. Pediatric and Developmental Pathology: The Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society Vol. 23(2), Pp. 79-95.

Roberts, S.K., Majeed, A., Kemp, W., 2021. Controversies in The Management of Hepatitis B: Hepatocellular Carcinoma. Clinics in Liver Disease Vol. 25(4), Pp. 785-803.

Roma, K., Chandler, T.-M., Dossaji, Z., Patel, A., Gupta, K., Minacapelli, C.D., Rustgi, V., Gish, R., 2024. A Review of The Systemic Manifestations of Hepatitis B Virus Infection, Hepatitis D Virus, Hepatocellular Carcinoma, and Emerging Therapies. Gastro Hep Advances Vol. 3(2), Pp. 276-291.

Tajiri, H., Takano, T., Tanaka, H., Ushijima, K., Inui, A., Miyoshi, Y., Ozono, K., Abukawa, D., Endo, T., Brooks, S., Tanaka, Y., 2016.

Hepatocellular Carcinoma in Children and Young Patients with Chronic HBV Infection and The Usefulness of Alpha-Fetoprotein Assessment. Cancer Medicine Vol. 5(111), Pp. 3102-3110.

Yang, T., Lu, J.-H., Lin, C., Shi, S., Chen, T.-H., Zhao, R.-H., Wang, Y., Wu, M.-C., 2012. Concomitant Lung Metastasis In Patients With Advanced Hepatocellular Carcinoma. World Journal of Gastroenterology Vol. 18(20), Pp. 2533-2539.

Yantie, N.V.K., Ariawati, K., Sanjaya, I.G.N., 2016. Karsinoma Hepatoselular pada Anak Usia 11 Tahun. Sari Pediatri Vol. 13(3), Pp. 179-84.

Yeh, S.-H., Li, C.-L., Lin, Y.-Y., Ho, M.-C., Wang, Y.-C., Tseng, S.-T., Chen, P.-J., 2023. Hepatitis B Virus DNA Integration Drives Carcinogenesis and Provides a New Biomarker for HBV-related HCC. Cell Mol Gastroenterol Hepatol Vol. 15(4), Pp. 921-929.

Yin, Y., Wu, L., Zhang, J., Zhou, J., Zhang, P., Hou, H., 2013. Identification of Risk Factors Associated with Immunoprophylaxis Failure to Prevent The Vertical Transmission of Hepatitis B Virus. The Journal of Infection Vol. 66(5), Pp. 447-452.

Zhao, P., Lu, Y., Wang, C., Wang, L., Li, J., Li, M., 2021. Clinical, Pathological and Genetic Characteristics of Pediatric Hepatocellular Carcinoma Associated with Hepatitis B Virus Infection. Journal of Hepatocellular Carcinoma Vol. 8, Pp. 361-367.

Zhuang, H., Peng, Y., Chen, T., Jiang, Y., Luo, Y., Zhang, Q., Yang, Z., 2011. The Comparison of Grey-Scale Ultrasonic and Clinical Features of Hepatoblastoma and Hepatocellular Carcinoma in Children: A Retrospective Study for Ten Years. BMC Gastroenterology Vol. 11(1), Pp. 78.

Ziogas, I.A., Ye, F., Zhao, Z., Matsuoka, L.K., Montenovo, M.I., Izzy, M., Benedetti, D.J., Lovvorn, H.N., Gillis, L.A., Alexopoulos, S.P., 2020. Population-Based Analysis of Hepatocellular Carcinoma in Children: Identifying Optimal Surgical Treatment. Journal of The American College of Surgeons Vol. 230(6), Pp. 1035-1044.e3.

Zou, H., Chen, Y., Duan, Z., Zhang, H., Pan, C., 2012. Virologic Factors Associated with Failure to Passive - Active Immunoprophylaxis in Infants Born to Hbsag‐Positive Mothers. Journal of Viral Hepatitis Vol. 19(2), Pp. e18-25.