Indocyanine green fluorescence-assisted laparoscopic hepatectomy for hepatocellular carcinoma in a pre-adolescent girl: a case report

摘要

We present the case of a 9-year-old Chinese girl who presented with an incidental finding of elevated alkaline phosphatase (349 U/L) during a routine medical examination in 2018. Further blood test results were positive for hepatitis B. The patient was prescribed entecavir 0.5 mg daily and underwent regular liver ultrasound scans. After 6 months, a tumour at the right lobe of the liver was identified during routine scanning, and serum alpha-fetoprotein was elevated at 489 ng/mL. Further investigation with contrast computed tomography scan revealed a 3.8-cm × 5.0-cm tumour at segment 5 of the liver with radiological features compatible with hepatocellular carcinoma (HCC, Fig 1a ). Liver function tests were normal (total bilirubin: 12 μmol/L, albumin 38 g/L, international normalised ratio:1.1). The patient’s body weight was 28 kg and her height was 128 cm. Figure 1. A 9-year-old Chinese girl with a tumour at segment 5 of the liver. (a) Computed tomography scan showing a 3.8-cm × 5.0-cm arterial enhancing hepatocellular carcinoma at segment 5 of the liver. (b) A 5-cm solitary tumour was identified on the surface of segment 5 under laparoscopy.The tumour became more distinguishable under near infrared fluorescence