title: Transcatheter arterial embolization and extrabeam radiation therapy for subcutaneous seeding of hepatocellular carcinoma by percutaneous ethanol injection.
abstract: A 74-year-old man with a hepatocellular carcinoma received percutaneous ethanol injection twice following the needle biopsy of the tumor. Two years and 6 months after percutaneous ethanol injection, a subcutaneous tumor, which appeared to be a needle tract seeding by percutaneous ethanol injection, was recognized in the right lower anterior chest wall. A curative surgical resection was impossible because of the patient's decreased coagulopathy and severe liver dysfunction. The disseminated tumor was treated with extrabeam radiotherapy (20 fractions; total dose of 50 grays) followed by transcatheter arterial embolization by means of superselective catherization. The size of the subcutaneous tumor was decreased to about 15 mm in diameter. Contrast medium enhanced computed tomography demonstrated no enhancement in the tumor. The patient is currently doing well without further recurrence of hepatocellular carcinoma and without enlargement of the subcutaneous tumor after extrabeam radiation therapy and transcatheter arterial embolization.
authors.affiliation: First Department of Internal Medicine, Mie University School of Medicine, Edobashi, 2-174, Tsu, 514-8507, Japan.
authors.forename: Takenari
authors.initials: T
authors.lastname: Yamanaka
authors.forename: Katsuya
authors.initials: K
authors.lastname: Shiraki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ito
authors.forename: Kazushi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Takahisa
authors.initials: T
authors.lastname: Sakai
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ohmori
authors.forename: Kojiro
authors.initials: K
authors.lastname: Takase
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakano
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary* / Q000628:therapy*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods*; D000431:Ethanol / Q000627:therapeutic use; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000628:therapy*; D008297:Male; D009366:Neoplasm Seeding; D011879:Radiotherapy Dosage; D014057:Tomography, X-Ray Computed
chemical_list: D000431:Ethanol