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Fontan手术及内脏反位后肝癌的重复经动脉化疗栓塞术：一例报告

Repeated TACE in HCC after Fontan surgery and situs viscerum inversus: A case report.

作者信息

Gasparrini Fulvio, Lenci Ilaria, Gagliardi Maria Giulia, Spada Marco, Salimei Fabio, Orlacchio Antonio

机构信息

Department of Diagnostic and Interventional Radiology, University Hospital Tor Vergata, Rome, Italy.

Liver Unit, University Hospital Tor Vergata, Rome, Italy.

出版信息

Radiol Case Rep. 2021 Jul 9;16(9):2564-2569. doi: 10.1016/j.radcr.2021.06.031. eCollection 2021 Sep.

DOI:10.1016/j.radcr.2021.06.031
PMID:34306288
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8283149/
Abstract

We describe the case of a 32-year-old man who developed a liver neoplasm due to previous Fontan surgery (FS) for a single ventricle anomaly and situs viscerum inversus. He was admitted to our hospital for suspected hepatocellular carcinoma during an Ultrasound (US) follow up. Computed tomography (CT) showed features of chronic liver disease and 7 cm hepatic nodule with arterial enhancement. Laboratory analyses documented preserved liver function and increased levels of alpha-fetoprotein. Trans-arterial-chemoembolization (TACE) was performed obtaining complete necrosis at 4 weeks of follow up and significant reduction of alpha-fetoprotein. The patient is currently in follow-up, being evaluated for further treatments and/or combined liver-heart transplantation. TACE is a therapeutic option for the treatment of patients with unresectable hepatocellular carcinoma (HCC) and with severe heart disease, like those submitted to FS and with also other vascular abnormalities like those correlated to situs viscerum inversus.

摘要

我们描述了一名32岁男性的病例，该患者因既往接受单心室异常和内脏反位的Fontan手术（FS）而发生肝脏肿瘤。在超声（US）随访期间，他因疑似肝细胞癌入住我院。计算机断层扫描（CT）显示慢性肝病特征以及一个7厘米的肝脏结节，伴有动脉强化。实验室分析显示肝功能正常，但甲胎蛋白水平升高。进行了经动脉化疗栓塞术（TACE），在随访4周时实现了完全坏死，甲胎蛋白显著降低。该患者目前正在接受随访，正在评估进一步的治疗和/或肝心联合移植。TACE是治疗不可切除肝细胞癌（HCC）且患有严重心脏病患者的一种治疗选择，例如接受FS手术且伴有与内脏反位相关的其他血管异常的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/f0f25f95e20e/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/aad15f50ab8a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/b0b422054577/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/fd110a87c44f/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/393790595a9c/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/73857b8781b6/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/e340d758b177/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/f0f25f95e20e/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/aad15f50ab8a/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/b0b422054577/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/fd110a87c44f/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/393790595a9c/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/73857b8781b6/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/e340d758b177/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8fd/8283149/f0f25f95e20e/gr7.jpg

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Radiol Case Rep. 2020 Oct 10;15(12):2602-2606. doi: 10.1016/j.radcr.2020.09.056. eCollection 2020 Dec.
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National trends in Fontan operation and in-hospital outcomes in the USA.美国 Fontan 手术的全国趋势及院内结局。
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Fontan-Associated Liver Disease: A Review.Fontan 相关肝疾病：综述。
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Benign nodules in post-Fontan livers can show imaging features considered diagnostic for hepatocellular carcinoma.法乐四联症根治术后肝脏良性结节可出现影像学表现，这些表现被认为对肝细胞癌具有诊断意义。
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