Management dilemma of hepatocellular carcinoma in pregnancy: a case report

Hepatocellular carcinoma is rarely associated with pregnancy and when it does there is poor prognosis for both the mother and the baby. There is paucity of evidence for best practice in hepatocellular carcinoma in pregnancy especially in the background of cirrhosis and decompensation. We present a 36 year old gravida 5 para 4 at 27 weeks gestation with hepatocellular carcinoma and main complaint of abdominal pain. She had chronic hepatitis B infection with hepatocellular carcinoma on a cirrhotic background. There were both clinical and laboratory features suggestive of liver decompensation. The pregnancy outcome was a fresh stillbirth with mother alive. This case report highlights the management dilemma of hepatocellular carcinoma in pregnancy on the background of decompensated liver cirrhosis and chronic hepatitis B infection.