Low specificity of washout to diagnose hepatocellular carcinoma in nodules showing arterial hyperenhancement in patients with Budd-Chiari syndrome

Wettere, Morgane Van; Purcell, Yvonne; Bruno, Onorina; Payancé, Audrey; Plessier, Aurélie; Rautou, Pierre‐Emmanuel; Cazals–Hatem, Dominique; Valla, Dominique; Vilgrain, Valérie; Ronot, Maxime

doi:10.1016/j.jhep.2019.01.009

Cited by 43 publications

(32 citation statements)

References 26 publications

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“…In some of our patients with biopsy-proven non-malignant lesions washout features were found. Interestingly, a low specificity of washout to diagnose hepatocellular carcinoma has been also recently described in a French cohort of patients with BCS [26]. In another recent study, it was shown that benign hyperenhancing nodules detected after FS may display washout and be mistaken for hepatocellular carcinoma according to imaging criteria [18].…”

Section: Discussionmentioning

confidence: 84%

Prevalence, features and predictive factors of liver nodules in Fontan surgery patients: The VALDIG Fonliver prospective cohort

Téllez

Santiago

Mínguez

et al. 2020

Journal of Hepatology

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Section: Discussionmentioning

confidence: 84%

Prevalence, features and predictive factors of liver nodules in Fontan surgery patients: The VALDIG Fonliver prospective cohort

Téllez

Santiago

Mínguez

et al. 2020

Journal of Hepatology

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“…( 205,206 ) HCC diagnosis in HVT/BCS is a challenge and must always rely on histology for diagnosis. A level of alpha‐fetoprotein >15 ng/mL has been suggested as a predictive biomarker for HCC in HVT/BCS patients ( 205,207 ) ; however, this threshold cannot be recommended in clinical practice until validated in larger studies. Although specific data are lacking, surveillance for HCC in patients with chronic HVT/BCS with ultrasound with or without alpha‐fetoprotein levels every 6 months is recommended.…”

Section: Clinical Presentation and Diagnostic Considerationsmentioning

confidence: 99%

Vascular Liver Disorders, Portal Vein Thrombosis, and Procedural Bleeding in Patients With Liver Disease: 2020 Practice Guidance by the American Association for the Study of Liver Diseases

et al. 2021

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“…[5][6][7] The situation might resemble that of other vascular diseases of the liver in which there is chronic venous congestion and fibrosis, such as Budd-Chiari syndrome, which also raises the risk of HCC. 8 The first case of HCC after FS was an autopsy finding in a 24-year-old man reported in 2005. 9 Since then, the topic has been the subject of several case reports and short series.…”

Section: Introductionmentioning

confidence: 99%

Hepatocellular carcinoma after Fontan surgery: A systematic review

Santiago

Téllez

Guerrero

et al. 2020

Hepatology Research

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Aim: Fontan surgery is often the procedure of choice for patients with congenital single effective ventricle. In the long term, elevated systemic venous pressure and chronic ischemia following this procedure could lead to advanced chronic liver disease and there is also a risk of hepatocellular carcinoma (HCC). This review systematically summarizes the characteristics and outcomes of this rare condition. Methods: PubMed and Embase databases were searched from inception to January 2020 for studies reporting on HCC after Fontan surgery. The factors analyzed were clinical presentation, histology, imaging findings, treatments, and survival. Our primary analysis was based on biopsy-proven HCC. Results: The records selected were 26 observational studies (19 case reports/case series and seven cohort studies) including 65 biopsy-proven HCC. Age at the time of HCC diagnosis ranged from 12 to 52 years, and 62% of the patients were female. Only one case occurred earlier than 10 years after Fontan surgery. Twenty patients had no imaging or histological evidence of liver cirrhosis and 78.3% had elevated α-fetoprotein levels. Advanced stage was the most common at diagnosis. The most frequent treatments were transarterial chemoembolization (n = 18) and surgery (n = 12). One-year survival was 50% and only four patients (6.2%) were under liver imaging surveillance. We also analyzed 17 patients with non-biopsy-proven HCC. Conclusions: After Fontan surgery, HCC usually occurs at least 10 years later and can develop in the absence of cirrhosis. Biopsy is mandatory to confirm the diagnosis. Patients were diagnosed at a late stage and survival outcomes were poor, highlighting a need for liver surveillance.

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Low specificity of washout to diagnose hepatocellular carcinoma in nodules showing arterial hyperenhancement in patients with Budd-Chiari syndrome

Cited by 43 publications

References 26 publications

Prevalence, features and predictive factors of liver nodules in Fontan surgery patients: The VALDIG Fonliver prospective cohort

Prevalence, features and predictive factors of liver nodules in Fontan surgery patients: The VALDIG Fonliver prospective cohort

Vascular Liver Disorders, Portal Vein Thrombosis, and Procedural Bleeding in Patients With Liver Disease: 2020 Practice Guidance by the American Association for the Study of Liver Diseases

Hepatocellular carcinoma after Fontan surgery: A systematic review

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