医学
肝细胞癌
失代偿
肝硬化
肝移植
并发症
甲基丙二酸血症
外科
移植
胃肠病学
高氨血症
肝切除术
内科学
切除术
作者
Hiroyuki Deguchi,Seisuke Sakamoto,Seiichi Shimizu,Akira Fukuda,Hajime Uchida,Yusuke Yanagi,Toshimasa Nakao,Tasuku Kodama,Ryuji Komine,Kentaro Nishi,Koichi Kamei,Chizuko Haga,Takako Yoshioka,Kimikazu Matsumoto,Reiko Horikawa,Mureo Kasahara
摘要
Abstract Background Methylmalonic acidemia (MMA) is an autosomal recessive disorder caused by defects in propionyl‐CoA (P‐CoA) catabolism; of note, liver neoplasms rarely occur as a long‐term complication of the disorder. Herein, we report the case of a patient with MMA and hepatocellular carcinoma (HCC) who was successfully treated with a living‐donor liver transplant (LDLT) following prior kidney transplantation. Case Report A 25‐year‐old male patient with MMA underwent LDLT with a left lobe graft because of metabolic instability and liver neoplasms. He had presented with chronic symptoms of MMA, which had been diagnosed by genetic testing. Additionally, he had undergone living‐donor kidney transplantation with his father as the donor due to end‐stage kidney disease 6 years before the LDLT. He had an episode of metabolic decompensation triggered by coronavirus disease in 2019. Imaging studies revealed an intrahepatic neoplasm in the right hepatic lobe. Due to concerns about metabolic decompensation after hepatectomy, LDLT was performed using a left lobe graft obtained from the patient's mother. Pathological findings were consistent with the characteristics of well‐to‐moderately differentiated HCC. The postoperative course was uneventful, and the patient was discharged 48 days after the LDLT without any complications. At the 9‐month follow‐up, the patient's condition was satisfactory, with sufficient liver graft function and without metabolic decompensation. Conclusion This case indicates that although HCC is a rare complication in patients with MMA, clinicians should be aware of hepatic malignancies during long‐term follow‐up.
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