title: Successful transcatheter chemoembolization for acute jaundice in a patient with advanced hepatocellular carcinoma and portal vein tumor thrombosis: a case report.
abstract: A 54-year-old man with suspected cirrhosis and a hepatic tumor on positron emission tomography presented to our hospital for assessment and treatment in January 2007. Laboratory tests and diagnostic imaging revealed that the patient had cirrhosis due to hepatitis B virus infection and advanced hepatocellular carcinoma (HCC) along with portal vein tumor thrombosis (PVTT) (T4N1M0, Child's B). After hospitalization, the serum levels of total and direct bilirubin increased markedly within several days (26.0 and 20.0 mg/dL), and biliary obstruction by the tumor appeared to have caused this sudden jaundice. To treat the biliary obstruction, selective transcatheter chemoembolization (TACE) was performed via the feeding arteries of the tumor in the anterior segment of the right lobe. After TACE, total bilirubin decreased to 7.0 mg/dL, and the patient survived for 4 more months.
authors.affiliation: Division of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan. inupi@nms.ac.jp
authors.forename: Keisuke
authors.initials: K
authors.lastname: Inui
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Komeichi
authors.forename: Yasumi
authors.initials: Y
authors.lastname: Katsuta
authors.forename: Shuji
authors.initials: S
authors.lastname: Shimizu
authors.forename: Kyouichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000208:Acute Disease; D001663:Bilirubin / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000098:blood supply / Q000175:diagnosis / Q000628:therapy* / Q000821:virology; D016461:Chemoembolization, Therapeutic; D004932:Esophageal and Gastric Varices / Q000209:etiology; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006509:Hepatitis B / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007565:Jaundice / Q000097:blood / Q000175:diagnosis / Q000628:therapy* / Q000821:virology; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis / Q000821:virology*; D008113:Liver Neoplasms / Q000097:blood / Q000098:blood supply / Q000175:diagnosis / Q000628:therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D011172:Portography; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000097:blood / Q000175:diagnosis / Q000628:therapy* / Q000821:virology
chemical_list: D001663:Bilirubin