HEPATOCELLULAR CARCINOMA IN CHILDREN: 2 CASE REPORT

Background:Hepatocellular carcinoma (HCC) is the second most common liver cancer in children.In this article we sought, through our two observations, to examine the evolving clinical aspect as well as the therapeutic management of hepatocellular carcinoma in children, since this affection is rare in the childhood. Case presentation:We report two cases of hepato carcinoma. The first case of an 11-year-old girl from Marrakech with glycogenosis complicated by hepatic cirrhosis at the portal hypertension stage. After diagnostic confirmation; the patient benefited from systemic treatment with Atezolimumab + Bevacizumab with good progress in the short term (5 months follow-up). The second case concerns a 14-year-old girl from Marrakech region with hepato carcinoma on a healthy liver who received the same treatment but the evolution was marked in the long term by an increase in the size of the mass and portal hypertension and death at age 17 years old. Conclusion: HCC is rare in childhood. The etiological predisposition and biological behavior differ from adults. In cases of cirrhosis or liver disease, HCC must be suspected based on a high AFP level and an abnormal nodule on ultrasound. Hepatoblastoma should be considered first in the differential diagnosis. Treatment of pediatric HCC is difficult. Complete surgical resection is essential to cure it. For tumors that cannot be resected, liver transplantation is decided on a case-by-case basis. However , HCC remains difficult to treat as cure requires complete surgical resection.