Hepatocellular carcinoma diagnosed in a patient who had Fontan operation 30 years ago: a case report.
Moon Haeng HurHaeryoung KimJeong-Hoon LeePublished in: Journal of liver cancer (2022)
The Fontan operation is performed in patients with a single ventricle. As the systemic venous return is directly connected to the pulmonary circulation during this procedure, chronic hepatic congestion is induced, leading to Fontan-associated liver disease (FALD) including liver cirrhosis and hepatocellular carcinoma (HCC). In this report, we present a case of HCC diagnosed in a patient who underwent the Fontan operation 30 years ago. The patient underwent regular surveillance for FALD, which revealed a 4 cm-sized hepatic mass with elevated serum alpha-fetoprotein. After surgical treatment, there was no evidence of HCC recurrence during 3 years of follow-up. As the risk of HCC and Fontan-associated liver cirrhosis increases with the duration elapsed since the operation, regular surveillance should be emphasized. Serial follow-up of serum alpha-fetoprotein levels and abdominal imaging are necessary to achieve early and accurate diagnosis of HCC in post-Fontan patients.
Keyphrases
- case report
- public health
- high resolution
- end stage renal disease
- pulmonary hypertension
- ejection fraction
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- minimally invasive
- pulmonary artery
- single cell
- mitral valve
- drug induced
- diabetic rats
- prognostic factors
- mass spectrometry
- high glucose
- left ventricular
- patient reported outcomes
- free survival