Percutaneous ethanol injection therapy of adenomatous hyperplastic nodules in cirrhotic liver disease.
Adenomatous hyperplastic nodules (AHNs) in cirrhotic liver are considered a precancerous condition which may lead to hepatocellular carcinoma (HCC). In this study, we treated a total of 23 AHNs in 15 patients with percutaneous ethanol injection (PEI). The treatment included 6 to 8 PEIs, performed on an out-patient basis under sonographic guidance. A 22 G (0.7 mm) spinal needle was used. The total amount of alcohol delivered into each lesion was 8 to 25 ml (mean 14.9 ml). At the end of treatment, complete necrosis of the nodule was proved in all cases by multiple fine-needle biopsies and confirmed by CT and MR findings. During follow-up (9-41 months, mean 24 months) no recurrences were demonstrated. However, HCC occurred elsewhere in the liver of 4 patients and additional AHNs were detected in 2 patients. Thus, PEI proved able to cause complete ablation of AHNs, presumably preventing their malignant transformation. However, patients with AHN remain at high risk for developing HCC.
Lencioni
R
R
Department of Radiology, University of Pisa, Italy.
Caramella
D
D
Bartolozzi
C
C
Mazzeo
S
S
Di Coscio
G
G
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007271:Injections, Intradermal; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000188:drug therapy*
D000431:Ethanol