{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T02:44:22Z","timestamp":1791081862358,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,12,2]],"date-time":"2013-12-02T00:00:00Z","timestamp":1385942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To elucidate the characteristics of hepatocellular carcinoma (<jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>) in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>A retrospective search of our database identified 12 children with <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> (aged 10\u00a0months to 11\u00a0years; male\/female ratio of 5:7). Their pathological features were compared with those of adult <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>s (<jats:italic>n<\/jats:italic>\u00a0=\u00a020), fibrolamellar <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>s (<jats:italic>n<\/jats:italic>\u00a0=\u00a014), and hepatoblastomas (<jats:italic>n<\/jats:italic>\u00a0=\u00a015). All childhood <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>s developed on a background of cirrhosis resulting from tyrosinaemia type 1 (<jats:italic>n<\/jats:italic>\u00a0=\u00a04), bile salt export transporter deficiency (<jats:italic>n<\/jats:italic>\u00a0=\u00a04), biliary atresia (<jats:italic>n<\/jats:italic>\u00a0=\u00a03), and long\u2010standing total parenteral nutrition (<jats:italic>n<\/jats:italic>\u00a0=\u00a01). <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>s in cases of tyrosinaemia type 1 always had clear cell changes, solid architecture, and only mild nuclear atypia, whereas the morphological features of <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>s in the other conditions were basically similar to those of adult <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>s. On immunostaining, all cases of childhood <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> were positive for epithelial cell adhesion molecule (Ep<jats:styled-content style=\"fixed-case\">CAM<\/jats:styled-content>); expression was diffuse (&gt;50% of cancer cells) in 11 cases, and particularly strong in six children, all aged &lt;3\u00a0years. In contrast, Ep<jats:styled-content style=\"fixed-case\">CAM<\/jats:styled-content> was only focally expressed in three cases of adult <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> (15%). Ep<jats:styled-content style=\"fixed-case\">CAM<\/jats:styled-content> was also expressed in most fibrolamellar <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>s and hepatoblastomas, but these two neoplasms differed from childhood <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>s in the expression of <jats:styled-content style=\"fixed-case\">CK<\/jats:styled-content>7, \u03b2\u2010catenin, and p53.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The diffuse expression of Ep<jats:styled-content style=\"fixed-case\">CAM<\/jats:styled-content> characterizes childhood <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>, and may indicate immaturity of neoplastic cells.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.12312","type":"journal-article","created":{"date-parts":[[2013,10,19]],"date-time":"2013-10-19T14:52:41Z","timestamp":1382194361000},"page":"671-682","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Childhood hepatocellular carcinoma: a clinicopathological study of 12 cases with special reference to Ep<scp>CAM<\/scp>"],"prefix":"10.1111","volume":"64","author":[{"given":"Yoh","family":"Zen","sequence":"first","affiliation":[{"name":"Histopathology Section Institute of Liver Studies King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshni","family":"Vara","sequence":"additional","affiliation":[{"name":"Department of Inherited Metabolic Disease Evelina Children's Hospital St Thomas\u2019 Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Portmann","sequence":"additional","affiliation":[{"name":"Histopathology Section Institute of Liver Studies King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nedim","family":"Hadzic","sequence":"additional","affiliation":[{"name":"Paediatric Centre for Hepatology, Gastroenterology and Nutrition King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,12,2]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"205","volume-title":"World Health Organization classification of tumours. 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