Year 2017 / Volume 109 / Number 5
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Hepatocellular carcinoma in a non-failing Fontan circulation

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Efrén Martínez-Quintana, Alberto Monescillo, Fayna Rodríguez-González,

Abstract
Patients after a Fontan operation exhibit some degree of fibrosis which are primarily located in a sinusoidal or centrilobular pattern. Cirrhosis may develop years later and the incidence of cancer is up to 5%. That is why some authors recommend that patients who are >10 years out from their Fontan operation should undergo cardiac assessment as well as the determination of alpha-fetoprotein level, the realization of liver imaging tests or even liver biopsy to stay ahead of neoplastic transformation.
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References
1.- Llovet JM, Ducreux M, Lencioni R, et al. European Association for Study of Liver; European Organisation for Research and Treatment of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. Eur J Cancer 2012;48:599-641.
2.- Asrani SK, Warnes CA, Kamath PS. Hepatocellular carcinoma after the Fontan procedure. N Engl J Med 2013;368:1756-7.
3.- Rychik J, Veldtman G, Rand E, et al. The precarious state of the liver after a Fontan operation: summary of a multidisciplinary symposium. Pediatr Cardiol. 2012;33(7):1001-12.
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Martínez-Quintana E, Monescillo A, Rodríguez-González F. Hepatocellular carcinoma in a non-failing Fontan circulation. 4651/2016


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Publication history

Received: 05/10/2016

Accepted: 19/10/2016

Published: 03/05/2017

Article editing time: 210 days


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