Hepatitis B surface antigen positive hepatocellular carcinoma in children. Report of a case and review of the literature.

This report describes a case of adult type hepatocellular carcinoma (HCC) of a ten-year-old boy. The liver showed no cirrhosis but hepatitis B surface antigen (HBs-antigen) was demonstrated in the non-neoplastic liver cells. Serological examination of his family revealed positive HBs-antigen of the patient's mother suggesting familial transmission to the patient in his early life. Histologic demonstration of HBs-antigen was performed on 36 adult HCC cases and 14 childhood cases including three HCC and eleven hepatoblastoma. HBs-antigen was demonstrated in 12 adult cases, one of which showed no cirrhosis. All childhood cases except for the one presented here showed no HBs-antigen. Review of the literature disclosed four other cases of HBs-antigen positive HCC in children. The present case is unique in that the non-neoplastic portion of the liver showed neither hepatitic nor cirrhotic manifestations. These HBs-antigen positive HCC in childhood may imply the significant relationship between HB virus and HCC not only in adult but also in childhood.