{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:21:00Z","timestamp":1777983660659,"version":"3.51.4"},"reference-count":12,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,8,25]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>Hepatocellular carcinoma (HCC) is an extremely rare long-term complication of Budd-Chiari syndrome (BCS) which may occur due to long-term venous congestion causing fibrosis, cirrhosis and subsequent hepatocellular dysplasia or anaplasia. This complication is even rarer in paediatric BCS and warrants early diagnosis for a favourable prognosis. Benign regenerative nodules seen with BCS are difficult to differentiate from malignant nodular lesion of HCC, thereby making serial imaging less sensitive for early diagnosis of HCC in BCS. Surveillance guidelines like adults do not exist in monitoring chronic paediatric BCS due to rarity of this complication. Six monthly serum alpha-fetoprotein monitoring in addition to radiological surveillance improves the sensitivity of early detection of HCC transformation in BCS and should be the way ahead in paediatric BCS as well. We describe a paediatric patient who presented with advanced HCC after 25-month follow-up for BCS.<\/jats:p>","DOI":"10.1136\/bcr-2024-261764","type":"journal-article","created":{"date-parts":[[2024,8,31]],"date-time":"2024-08-31T12:05:13Z","timestamp":1725105913000},"page":"e261764","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Hepatocellular carcinoma as a complication of chronic Budd-Chiari syndrome (BCS) in a child"],"prefix":"10.1136","volume":"17","author":[{"given":"Divyanshi","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Army Hospital Research and Referral, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4754-8340","authenticated-orcid":false,"given":"Sanjeev","family":"Khera","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Army Hospital Research and Referral, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ganesh","family":"Saravagi","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Army Hospital Research and Referral, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pawan Kumar","family":"Dhaman","sequence":"additional","affiliation":[{"name":"Department of Pathology, Army Hospital Research and Referral, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,8,31]]},"reference":[{"key":"2025082704103178000_17.8.e261764.1","doi-asserted-by":"crossref","first-page":"515","DOI":"10.2147\/JBM.S278678","article-title":"Epidemiological Characteristics and Etiology of Budd-Chiari Syndrome in Upper Egypt","volume":"11","author":"Abdel Hameed","year":"2020","journal-title":"J Blood Med"},{"key":"2025082704103178000_17.8.e261764.2","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1097\/00005792-199401000-00003","article-title":"Hepatic Outflow Obstruction (Budd-Chiari Syndrome) Experience with 177 Patients and a Review of the Literature","volume":"73","author":"Dilawari","year":"1994","journal-title":"Med Abingdon"},{"key":"2025082704103178000_17.8.e261764.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(88)80524-9"},{"key":"2025082704103178000_17.8.e261764.4","doi-asserted-by":"crossref","first-page":"1946","DOI":"10.3748\/wjg.v18.i16.1946","article-title":"Hepatocellular carcinoma in Budd-Chiari syndrome: a single center experience with long-term follow-up in South Korea","volume":"18","author":"Park","year":"2012","journal-title":"World J Gastroenterol"},{"key":"2025082704103178000_17.8.e261764.5","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.139477"},{"key":"2025082704103178000_17.8.e261764.6","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1007\/s13312-016-0941-x","article-title":"Ruptured Hepatocellular Carcinoma in a Child with Budd-Chiari Syndrome","volume":"53","author":"Suri","year":"2016","journal-title":"Indian Pediatr"},{"key":"2025082704103178000_17.8.e261764.7","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1097\/MEG.0000000000000144","article-title":"Budd-Chiari syndrome in children: clinical features, percutaneous radiological intervention, and outcome","volume":"26","author":"Kathuria","year":"2014","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"2025082704103178000_17.8.e261764.8","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1007\/s13312-018-1397-y","article-title":"Pediatric Budd-Chiari Syndrome: A Case Series","volume":"55","author":"Redkar","year":"2018","journal-title":"Indian Pediatr"},{"key":"2025082704103178000_17.8.e261764.9","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1097\/MEG.0000000000000583","article-title":"Long-term clinical outcome of Budd-Chiari syndrome in children after radiological intervention","volume":"28","author":"Sharma","year":"2016","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"2025082704103178000_17.8.e261764.10","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.071423"},{"key":"2025082704103178000_17.8.e261764.11","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.09.023"},{"key":"2025082704103178000_17.8.e261764.12","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1002\/hep.20933","article-title":"Practice Guidelines Committee, American Association for the Study of Liver Diseases. 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