SURGICAL MANAGEMENT OF POSTPARTUM HEPATOCELLUAR CARCINOMA OF LIVER- A RARE CASE REPORT

Background Hepatocellular carcinoma is highly prevalent in group of population with Hepatitis B virus infection and aflotoxin ingestion. Hepatocellular carcinoma in pregnancy and postpartum period is rare.Only few cases reported from literature.Case ReportThis is a case report of a young lady, age of 21years, Primi presented with mass abdomen on the 20th postpartum day. She had dull aching pain of 20 days duration in Right hyphochondrium. She had loss of weight appetite for 15 days. She had no fever no jaundice .She never consumed oral contraceptive Pills. Patient had no malena and no hematemesis. CECT abdomen showed enlarged liver with a large lobulated heterogenous necrotic mass occupying segments 5, 6, 7 and 8 with a large inferior exophytic component. S.AFP was elevated (1266 IUml). Upper GI endoscope showed antral erosions and extraneous impression at D1 .She had no Cirrhosis and Portal hypertension .Her Portal Doppler was normal .Her Viral markers were negative for Hepatitis B,C.She underwent Right Hepatectomy in our Institution Patient underwent R0 resection.She had adequate remnant liver volume .Patient didn't develop any post hepatectomy liver failure. No adjuvant chemotherapy was given .Patient was followed up with USG abdomen and S.AFP.Patient didnt develop any recurrence on follow up for the past 2 years. Conclusion HCC can occur in young age during the postpartum period, without prior liver disease like cirrhosis and viral hepatitis .But prognosis is good if diagnosed and resected early. The role pregnancy, Breast feeding and sex hormones in the progression of HCC must be evaluated