Surgical Resection for Hepatocellular Carcinoma with Cardiac Cirrhosis after the Fontan Procedure

Yoshitaka Takuma; Yuji Fukada; Shota Iwadou; Hirokazu Miyatake; Shuji Uematsu; Ryoichi Okamoto; Daisuke Sato; Hiroyoshi Matsukawa; Shigehiro Shiozaki; Masahiro Kamada; Toshiaki Morito; Yasuyuki Araki

doi:10.2169/internalmedicine.55.6869

CASE REPORTS

Surgical Resection for Hepatocellular Carcinoma with Cardiac Cirrhosis after the Fontan Procedure

Yoshitaka Takuma, Yuji Fukada, Shota Iwadou, Hirokazu Miyatake, Shuji Uematsu, Ryoichi Okamoto, Daisuke Sato, Hiroyoshi Matsukawa, Shigehiro Shiozaki, Masahiro Kamada, Toshiaki Morito, Yasuyuki Araki

Author information

Yoshitaka Takuma
Department of Internal Medicine, Hiroshima City Hospital, Japan
Yuji Fukada
Department of Internal Medicine, Hiroshima City Hospital, Japan
Shota Iwadou
Department of Internal Medicine, Hiroshima City Hospital, Japan
Hirokazu Miyatake
Department of Internal Medicine, Hiroshima City Hospital, Japan
Shuji Uematsu
Department of Internal Medicine, Hiroshima City Hospital, Japan
Ryoichi Okamoto
Department of Internal Medicine, Hiroshima City Hospital, Japan
Daisuke Sato
Department of Surgery, Hiroshima City Hospital, Japan
Hiroyoshi Matsukawa
Department of Surgery, Hiroshima City Hospital, Japan
Shigehiro Shiozaki
Department of Surgery, Hiroshima City Hospital, Japan
Masahiro Kamada
Department of Pediatric Cardiology, Hiroshima City Hospital, Japan
Toshiaki Morito
Department of Pathology, Hiroshima City Hospital, Japan
Yasuyuki Araki
Department of Internal Medicine, Hiroshima City Hospital, Japan

Keywords: hepatocellular carcinoma (HCC), Fontan, cardiac cirrhosis, surgical resection

JOURNAL OPEN ACCESS

2016 Volume 55 Issue 22 Pages 3265-3272

DOI https://doi.org/10.2169/internalmedicine.55.6869

Details

Abstract

A 29-year-old woman who underwent the Fontan procedure at 10 years of age had an incidental finding of liver masses on abdominal ultrasonography. Subsequent gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid magnetic resonance imaging showed a 15 mm hypervascular mass with washout in the hepatobiliary phase in liver segment 4 (S4), and an 18 mm hypervascular mass without washout in the hepatobiliary phase in liver segment 2 (S2). The S2 liver mass was pathologically diagnosed to be a regenerative nodule by an ultrasound-guided needle biopsy, and the S4 liver mass was pathologically diagnosed as a poorly differentiated hepatocellular carcinoma after partial hepatectomy.

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