Rosenbaum Jeremy, Vrazas John, Lane Geoffrey K, Hardikar Winita
Department of Gastroenterology, Royal Children's Hospital, Melbourne, Victoria, Australia.
J Paediatr Child Health. 2012 Mar;48(3):E140-3. doi: 10.1111/j.1440-1754.2010.01932.x. Epub 2010 Dec 29.
Increasing numbers of children are surviving into adulthood following surgery to correct or palliate congenital heart disease. This surgery can occasionally result in long-standing elevated right heart pressures and chronic hepatic venous congestion leading to cardiac cirrhosis. We report the first paediatric case of hepatocellular carcinoma in the setting of cardiac cirrhosis. A 13-year-old girl developed inoperable hepatocellular carcinoma and was treated with transarterial embolization with lipiodol and doxorubicin eluting microbeads. Promoting awareness of this association, even in younger patients, will hopefully result in better surveillance and screening of hepatic complications in survivors of complex cardiac surgery.
越来越多患有先天性心脏病的儿童在接受矫正或姑息性手术后存活至成年。这种手术偶尔会导致右心压力长期升高和慢性肝静脉淤血，进而引发心源性肝硬化。我们报告了首例在心源性肝硬化背景下发生肝细胞癌的儿科病例。一名13岁女孩患上无法手术切除的肝细胞癌，并接受了经动脉用碘油和阿霉素洗脱微球进行栓塞治疗。提高对这种关联的认识，即使是在较年轻的患者中，有望在复杂心脏手术幸存者中更好地监测和筛查肝脏并发症。
