Gastrointestinal neuroendocrine tumors in Fontan patients

• Main Authors: Corey Vural, BA, Priya Skaria, MBBS, Louis P. Dehner, MD, Geetika Khanna, MD, MS
• Format: Article
• Language: English
• Published: Elsevier 2020-11-01
• Series: Radiology Case Reports
• Subjects: Fontan procedure; Neuroendocrine tumors; Pancreas; Jejunum
• Online Access: http://www.sciencedirect.com/science/article/pii/S1930043320303988
• ISSN: 1930-0433

The Fontan procedure used for palliation of single ventricle physiology is associated with multisystemic morbidity. With improving survival and increased use of surveillance imaging in this patient population, long-term complications associated with Fontan circuits are commonly encountered by radiologists. One interesting observation is the apparent increased risk of paragangliomas and pheochromocytomas in this group of patients and perhaps a pathogenetic role of chronic hypoxia. We report 2 cases of gastrointestinal neuroendocrine tumors (NET) in the setting of Fontan circuit. The first is a 20-year-old female with history of hypoplastic left heart and Fontan palliation who presented with hematochezia and was diagnosed with a jejunal grade 2 NET. The second case is of a 12-year-old boy with history Fontan palliation for single ventricle physiology, incidentally found to have a well-differentiated pancreatic NET during precardiac transplant workup. These cases should alert the radiologists to be aware of the apparent association between Fontan procedure and NET.