Chemoembolization for hepatocellular carcinoma supplied by a lumbar artery.
OBJECTIVE
To describe the radiologic findings and imaging response of hepatocellular carcinoma (HCC) supplied by the lumbar artery.


METHODS
Between April 2004 and December 2012, we encountered HCC supplied by a lumbar artery in 21 patients. Two investigators retrospectively reviewed clinical and radiological findings of HCC supplied by the lumbar artery using computed tomography (CT) scans and digital subtraction angiograms.


RESULTS
Patients had received 1-27 sessions of previous chemoembolization procedures (mean 7.7 sessions, median 4 sessions). Mean tumor size was 5.3 cm. The locations of HCC supplied by lumbar artery were the bare area (n = 14, 67 %) and segment VI (n = 7, 33 %). Tumor-feeding arteries arose from the main lumbar artery (n = 7), proximal anterior division (n = 4), and distal anterior division (n = 14). In 20 patients, selective chemoembolization through the tumor-feeding arteries of the lumbar artery was achieved. In 1 patient, nonselective embolization at the main lumbar artery was performed. There was no complication such as skin necrosis or paralysis. On the first follow-up enhanced CT scan, target tumors fed by the lumbar artery showed complete response (n = 6), partial response (n = 4), stable disease (n = 3), and progressive disease (n = 8), but overall tumor response was partial response (n = 1) and progressive disease (n = 20).


CONCLUSIONS
When HCC is located in the inferior tip or bare area of the liver, a lumbar artery may supply the tumor. Although selective chemoembolization via the tumor-feeding vessel of the lumbar artery can be achieved in most cases, overall tumor response is commonly unfavorable.
Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea, seoul49@naver.com.
Han Myun
HM
Kim
Hyo-Cheol
HC
Kim
Sungmin
S
Woo
Kyu Ri
KR
Son
Seong Whi
SW
Cho
Jin Wook
JW
Chung
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D001158:Arteries; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D004317:Doxorubicin / Q000008:administration & dosage; D004998:Ethiodized Oil / Q000008:administration & dosage; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D008161:Lumbosacral Region / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D015588:Observer Variation; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult
D000903:Antibiotics, Antineoplastic; D004998:Ethiodized Oil; D004317:Doxorubicin