title: Successful treatment of large-size advanced hepatocellular carcinoma by transarterial chemoembolization followed by the combination therapy of percutaneous ethanol-lipiodol injection and radiofrequency ablation.
abstract: We report a case of large-size hepatocellular carcinoma (HCC) successfully treated with transarterial chemoembolization (TACE) followed by the combination therapy of percutaneous ethanol-lipiodol injection and radiofrequency ablation (PELI-RFA) and percutaneous ethanol-lipiodol injection (PELI) therapy. In the present case, the patient had a large-size advanced HCC, 7 cm in diameter, located in the S8 region of the liver. In addition, the hepatic reserve of the patient was severely poor. In order not to impair the poor hepatic reserve, we chose PELI-RFA and PELI, originally developed in our department and reported as milder treatment modalities than others. After TACE , PELI-RFA and PELI were performed several times, the HCC was totally destroyed and early enhancement shown by helical dynamic computed tomography disappeared completely after treatment. The hepatic reserve of the patient was not impaired by the series of treatments. Serum levels of tumor markers, alpha-fetoprotein and Des-gamma-carboxy prothrombin, were rapidly decreased to almost normal levels. PELI-RFA and PELI may be effective for the treatment of large-size HCC of patients with poor hepatic reserve.
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Ikenobe, Kagawa 761-0793, Japan.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Kurokohchi
authors.forename: Naoki
authors.initials: N
authors.lastname: Hosomi
authors.forename: Akira
authors.initials: A
authors.lastname: Yoshitake
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Ohgi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ono
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Maeta
authors.forename: Takaaki
authors.initials: T
authors.lastname: Kiuchi
authors.forename: Ichiro
authors.initials: I
authors.lastname: Matsumoto
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Masaki
authors.forename: Hirohito
authors.initials: H
authors.lastname: Yoneyama
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Kohi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kuriyama
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage*; D008113:Liver Neoplasms / Q000098:blood supply / Q000628:therapy*
chemical_list: D000431:Ethanol; D007459:Iodized Oil