title: [A case of successful treatment using "wrapping therapy" for huge hepatocellular carcinoma].
abstract: This case is about a male in his 50's. In May 2004, he consulted a nearby doctor with abdominal pain and was pointed out a huge mass in the liver. He was diagnosed as hepatocellular carcinoma over 10 cm in diameter with chronic hepatitis type B. Because the tumor concurred with intra-hepatic metastasis along with lymph node metastasis, we planned transhepatic arterial embolization (TAE) as a first choice of treatment and performed twice. However, because of the tail inside part of the tumor was supplied from the gastroduodenal artery (GDA) and right gastroepiploic artery (RGEA) which were nutrient arteries, an effective TAE was impossible. The enhancement lesion that seemed viable was shown by enhanced CT. Therefore, a wrapping therapy (surgical decollateralization+silicon membrane sheeting) was performed under laparotomy for the purpose of cutting off blood supply to the part of the viable lesion in August of the same year. The tail inside part of the tumor that seemed viable fell into necrosis by wrapping alone, and the serum PIVKA-II level decreased within normal limit. As of ten months after the treatment, the patient is still alive without aggravation.
authors.affiliation: Dept. of Gastrointestinal Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases.
authors.forename: Terumasa
authors.initials: T
authors.lastname: Yamada
authors.forename: Yo
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kishi
authors.forename: Shingo
authors.initials: S
authors.lastname: Noura
authors.forename: Ko
authors.initials: K
authors.lastname: Takachi
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Eguchi
authors.forename: Isao
authors.initials: I
authors.lastname: Miyashiro
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohue
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yano
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ohigashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishikawa
authors.forename: Shingi
authors.initials: S
authors.lastname: Imaoka
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D003097:Collateral Circulation; D013505:Digestive System Surgical Procedures / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged