Successful Liver Transplantation for Hyperammonemic Fibrolamellar Hepatocellular Carcinoma.

Abstract

Fibrolamellar hepatocellular carcinoma is a rare hepatocellular tumor usually arising in noninfected and noncirrhotic livers. Only 2 cases accompanied by hyperammonemia due to intrahepatic shunting have been reported. A 23-year-old white woman presented with a 2-week history of nausea, vomiting, generalized weakness, and intermittent right upper quadrant pain. Abdominal computerized tomography revealed a 13 x 9-cm hepatic mass. Core-needle biopsy revealed fibrolamellar hepatocellular carcinoma. She presented with coma due to hyperammonemia levels (peak at 437 mcg/dL) but without metastatic disease. She was urgently transplanted, started on daily sorafenib 8 weeks after transplantation, and was free of disease at 1 year after transplantation.

• Authors: Angel E Alsina, Edson Franco, Ahmad Nakshabandi, Christopher Albers, Nyingi Kemmer, Andrew C Berry, Jon Finan
• Journal: ACG case reports journal (ACG Case Rep J) Vol. 3 Issue 4 Pg. e106 (Aug 2016) ISSN: 2326-3253 [Print] United States
• PMID: 27807568 (Publication Type: Case Reports)