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KMID : 1039320220220020188
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Journal of Liver Cancer
2022 Volume.22 No. 2 p.188 ~ p.193
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Hepatocellular carcinoma diagnosed in a patient who had Fontan operation 30 years ago: a case report
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Hur Moon-Haeng
Kim Hae-Ryoung
Lee Jeong-Hoon
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Abstract
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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.
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KEYWORD
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Liver cancer, Fontan operation, Fontan-associated liver disease, Case report
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