We describe the case of a 41-year-old woman who developed a liver neoplasm due to previous Fontan surgery for a single ventricle anomaly and pacemaker implantation. She was admitted to our hospital for moderate ascites and she was affected by hepatocellular carcinoma treated by trans-arterial chemoembolization (TACE). Computed tomography showed features of chronic liver disease and 4 cm hepatic nodules with arterial enhancement. Laboratory analyses documented preserved liver function and increased levels of alpha-fetoprotein. TACE was performed obtaining complete necrosis at 4 weeks of follow up and significant reduction of alpha-fetoprotein after 2 months. 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 HCC and with severe heart disease, like those submitted to FS.
Keywords: 18F-FDG, 2-deoxy-2-[fluorine-18]fluoro- D-glucose; Cardiac cirrhosis; Congenital heart disease; DSA, Digital Subtraction Angiography; Fontan operation; HCC, hepatocellular carcinoma; Hepatocellular carcinoma; PET-CT, positron emission tomography; TACE, Trans Arterial ChemoEmbolization; US, ultrasound; ceCT, contrast enhanced Computed Tomography; trans-arterial embolization.
© 2020 The Authors. Published by Elsevier Inc. on behalf of University of Washington.