Hepatocellular carcinoma in two patients with cardiac cirrhosis Journal Article
| Authors: | Saliba, T.; Dorkhom, S.; O'Reilly, E. M.; Ludwig, E.; Gansukh, B.; Abou-Alfa, G. K. |
| Article Title: | Hepatocellular carcinoma in two patients with cardiac cirrhosis |
| Abstract: | Hepatocellular carcinoma has been commonly associated with multiple etiologic factors including hepatitis B and C, alcoholic liver disease, and more rarely congenital metabolic liver diseases. 'Cardiac cirrhosis' is the cirrhosis resulting from prolonged passive liver venous congestion secondary to right-sided congestive heart failure; hepatocellular carcinoma is a rarely reported outcome. In this study we present two female patients with congenital heart defects treated with the Fontan procedure who survived into their third decade, and developed hepatocellular carcinoma in the setting of cardiac cirrhosis. The Fontan procedure diverts blood from the inferior vena cava and superior vena cava to the pulmonary arteries, thereby increasing survival in infants born with a single effective ventricle. As such patients live longer, however elevated pulmonary and right-sided heart pressures cause chronic passive liver congestion and eventual cardiac cirrhosis. The two patients in this study had no risk factors for hepatocellular carcinoma other than cardiac cirrhosis secondary to their prolonged survival after their Fontan procedure. In conclusion, we suggest that cardiac cirrhosis may be a risk factor for developing hepatocellular carcinoma and recommend close follow-up and hepatocellular carcinoma screening for patients with known right heart failure and passive hepatic congestion. © 2010 Wolters Kluwer Health | Lippincott Williams and Wilkins. |
| Keywords: | adult; human tissue; case report; hepatocellular carcinoma; sorafenib; cisplatin; fluorouracil; ascites; gastrointestinal hemorrhage; liver cell carcinoma; liver cirrhosis; carcinoma, hepatocellular; liver neoplasms; anorexia; edema; computer assisted tomography; continuous infusion; fibrosis; heart failure; splenomegaly; fatal outcome; congestive heart failure; myocardium; congenital heart malformation; heart defects, congenital; heart right ventricle failure; cardiomegaly; heart ventricle septum defect; liver necrosis; cardiac cirrhosis; fontan procedure; arteriovenous malformation; great vessels transposition; heart atrium septum defect; heart cirrhosis; heart valve prosthesis; liver congestion; right heart hypoplasia; tricuspid valve atresia; varicosis; venous congestion |
| Journal Title: | European Journal of Gastroenterology and Hepatology |
| Volume: | 22 |
| Issue: | 7 |
| ISSN: | 0954-691X |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2010-07-01 |
| Start Page: | 889 |
| End Page: | 891 |
| Language: | English |
| DOI: | 10.1097/MEG.0b013e32832e2bec |
| PUBMED: | 19550346 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: EJGHE" - "Source: Scopus" |
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