title: Transarterial embolization for pediatric hepatocellular carcinoma with cardiac cirrhosis.
abstract: We describe the case of a 15-year-old boy with a history of Fontan operation and multiple intrahepatic tumors. Computed tomography showed multiple hepatic nodules with arterial enhancement. Because hepatocellular carcinoma (HCC) was not detected on biopsies and tumor markers were normal, progress was monitored on imaging. One hepatic tumor increased greatly in size during follow up. At 15 years of age, tumor markers rose rapidly, and he had upper abdominal swelling. Therefore, transarterial embolization (TAE) was performed for the largest tumor, suspected to be a HCC due to cardiac cirrhosis. This tumor had not increased at follow up 4 months later. The patient died from hepatic failure at the age of 17 years, and HCC was diagnosed at autopsy. Although pediatric HCC is rare, its incidence is likely to increase. TAE, with or without anticancer agents, is a therapeutic option for unresectable pediatric HCC, as it is for adult HCC.
authors.affiliation: Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shinmoto
authors.affiliation: Department of Pediatrics, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kawamura
authors.affiliation: Department of Pediatrics, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Wakamatsu
authors.affiliation: Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Kawauchi
authors.affiliation: Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Soga
authors.affiliation: Laboratory Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Ogata
authors.affiliation: Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Tatsumi
authors.initials: T
authors.lastname: Kaji
mesh_terms: D000293:Adolescent; D015901:Angiography, Digital Subtraction; D014408:Biomarkers, Tumor; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D017809:Fatal Outcome; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008297:Male; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor
keywords: Fontan operation; cardiac cirrhosis; congenital heart disease; hepatocellular carcinoma; transarterial embolization