Successful treatment of hypovascular advanced hepatocellular carcinoma with lipiodol-targetting intervention radiology.
We report a case of hypovascular advanced hepa-tocellular carcinoma (HCC) successfully treated with a novel combination therapy of percutaneous ethanol-lipiodol injection (PELI) and intervention radiology (IVR), lipiodol-targetting IVR (Lipi-IVR). The present case had a hypovascular HCC (3 cm in diameter) located in the S6 region of the liver. Although the tumor was not detectable at all by both of early and late phase of helical dynamic computed tomography (CT), it could be detected by ultrasonography (US) as a low echoic space occupying lesion (SOL) beside the gallbladder and right kidney. Serum levels of alpha fetoprotein (AFP) and AFP-L3 were extremely high. Combination therapy of PELI, firstly reported in our department, and IVR (PELI and IVR, lipiodol-targetting IVR) was performed twice for the treatment. PELI could effectively visualize the location of the tumor for IVR treatment and show the presence of a thin blood vessel branching from the right hepatic artery flowing into the lipiodol deposit. After treatment, the serum levels of AFP and AFP-L3 were rapidly decreased to normal and maintained for more than eight months. Thus, this case expressing the tremendous effect might give us insight into the effectiveness of the novel combination therapy of PELI and IVR for the treatment of hypovascular HCC.
Kurokohchi
Kazutaka
K
Department of Gastroenterology and Neurology, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. kuroko@med.kagawa-u.ac.jp
Deguchi
Akihiro
A
Masaki
Tsutomu
T
Himoto
Takashi
T
Yoneyama
Hirohito
H
Kobayashi
Mitsuyoshi
M
Maeta
Tsuyoshi
T
Kiuchi
Takaaki
T
Kohi
Fumikazu
F
Miyoshi
Hisaaki
H
Taminato
Tomohiko
T
Kuriyama
Shigeki
S
D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D003287:Contrast Media / Q000627:therapeutic use*; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D007459:Iodized Oil / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D008875:Middle Aged; D015642:Radiology, Interventional / Q000379:methods*
D000964:Antimetabolites, Antineoplastic; D003287:Contrast Media; D007459:Iodized Oil; D005472:Fluorouracil
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