title: Needle tract implantation of hepatocellular carcinoma after percutaneous ethanol injection.
abstract: BACKGROUND
  Percutaneous ethanol injection (PEI) therapy currently is widely used for small hepatocellular carcinoma (HCC). However, only limited information is available regarding needle tract implantation after PEI treatment.
  
  
  METHODS
  Records of HCC patients who underwent PEI between March 1990 and April 1997 at the National Cancer Center Hospital (n = 177) were reviewed to clarify the incidence, risk factors, and outcome of needle tract implantation of HCC.
  
  
  RESULTS
  PEI was performed for 348 HCC patients with a median tumor size of 20 mm. Needle tract implantation was found in 4 patients (10, 13, 15, and 46 months, respectively, after PEI). The size of the PEI-treated HCC tumors in these patients was 20, 27, 28, and 30 mm, respectively, in greatest dimension. All tumors were enhanced in the early phase on dynamic computed tomography (CT), and were found to have moderate tumor cell differentiation on biopsied specimens. Of the four implanted tumors, three were resected and the remaining tumor was treated with extrabeam radiotherapy. At last follow-up, 2 of the 4 patients had died (1 of variceal bleeding 60 months after PEI and the other from cancer 61 months after PEI) and 2 were still alive (14 and 20 months, respectively, after PEI) with no evidence of active tumor.
  
  
  CONCLUSIONS
  Needle tract implantation after PEI is not unusual, especially when HCC tumors are > or =2 cm in greatest dimension, enhanced in the early phase on dynamic CT, and/or moderately differentiated on biopsied specimens.
authors.affiliation: Department of Internal Medicine, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ishii
authors.forename: S
authors.initials: S
authors.lastname: Okada
authors.forename: T
authors.initials: T
authors.lastname: Okusaka
authors.forename: M
authors.initials: M
authors.lastname: Yoshimori
authors.forename: H
authors.initials: H
authors.lastname: Nakasuka
authors.forename: K
authors.initials: K
authors.lastname: Shimada
authors.forename: S
authors.initials: S
authors.lastname: Yamasaki
authors.forename: Y
authors.initials: Y
authors.lastname: Nakanishi
authors.forename: M
authors.initials: M
authors.lastname: Sakamoto
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology*; D000431:Ethanol / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015552:Injections, Intralesional / Q000009:adverse effects*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009339:Needles / Q000009:adverse effects*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000431:Ethanol