Robust Effect of Hepatic Arterial Infusion Chemotherapy and Radiation Therapy on Hepatocellular Carcinoma Arising from Fontan-associated Liver Disease

Intern Med. 2022 Apr 15;61(8):1145-1150. doi: 10.2169/internalmedicine.8154-21. Epub 2021 Sep 25.

Abstract

Fontan-associated liver disease (FALD) caused by long-term systemic venous congestion following the Fontan procedure may eventually lead to hepatocellular carcinoma (HCC). Treatment strategies for HCC due to FALD (FALD-HCC) remain unclear. We herein report a 35-year-old man with FALD-HCC that was well controlled by 3 cycles of continuous infusion of 5-fluorouracil and low-dose cisplatin (low-dose FP therapy) combined with 60 Gy of radiation therapy. However, the patient ultimately died of extrahepatic metastases. A pathological autopsy revealed more than 90% necrosis in the primary HCC lesion. This case suggests that low-dose FP therapy might be effective in FALD-HCC.

Keywords: Fontan-associated liver disease; hepatocellular carcinoma; low-dose FP therapy; radiation therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma, Hepatocellular* / etiology
  • Carcinoma, Hepatocellular* / therapy
  • Cisplatin / therapeutic use
  • Fluorouracil / therapeutic use
  • Fontan Procedure* / adverse effects
  • Humans
  • Infusions, Intra-Arterial / adverse effects
  • Liver Neoplasms* / pathology
  • Male
  • Postoperative Complications / etiology

Substances

  • Cisplatin
  • Fluorouracil