Successful treatment of large-size advanced hepatocellular carcinoma by transarterial chemoembolization followed by the combination therapy of percutaneous ethanol-lipiodol injection and radiofrequency ablation.
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.
Kurokohchi
Kazutaka
K
Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Ikenobe, Kagawa 761-0793, Japan.
Hosomi
Naoki
N
Yoshitake
Akira
A
Ohgi
Tomohiro
T
Ono
Masahiro
M
Maeta
Tsuyoshi
T
Kiuchi
Takaaki
T
Matsumoto
Ichiro
I
Masaki
Tsutomu
T
Yoneyama
Hirohito
H
Kohi
Fumikazu
F
Kuriyama
Shigeki
S
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*
D000431:Ethanol; D007459:Iodized Oil