女児にみられた HCG 産生肝芽腫の1例

概要

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Human chorionic gonadotropine (hCG) production by childhood hapatoblastoma is rare. Review of the literature reveals 34 such cases and all the patients were male. We first observed in 2 years female baby with hCG producing hepatoblastoma. She was admitted complaining of an abdominal mass and was diagnosed as hepatoblastoma. Laboratory examinations showed that the serum alphafetoprotein (AFP) was 192ng/ml, hCG 2,100IU/l, and urinary hCG 400IU/l. There was no sign of precocious puberty. Transarterial embolization (TAE) and chemotherapy were done for the unresectable tumor. Soon after the treatment, the tumor size decreased and hCG decreased to normal but serum AFP increased remarkably. Two months after TAB the tumor was removed by extended right hepatic lobectomy. The resected tumor measured 14×12×5 cm and weighed 430g. Immunohistochemically hCG was stained positive in some of the giant cells of hepatoblastoma. The tumor tissue contained hCG 20mIU/g wet weight. Postoperatively, the serum AFP decreased. But it tended to increase again 6 months after operation. The female lack of hCG producing tumor considered to simply due to the absense of FSH activity in hCG. But this hypothesis must be confirmed by other workers.
日本小児外科学会の論文
1988-10-20