A case of resected hepatocellular carcinoma after drug-eluting bead transarterial chemoembolization.
We report a case of resected hepatocellular carcinomas (HCCs) after drug-eluting bead transarterial chemoembolization (DEB-TACE). A 67-year-old man with alcoholic liver disease was diagnosed with HCCs. Serological markers for hepatitis B and C viruses were negative. Among tumor markers, alpha-fetoprotein was 2.7ng/mL, and protein induced by vitamin K absence II was 868mAU/mL. Two HCCs were detected using dynamic computed tomography: one was 9cm in diameter in S8 and the other was 2cm in diameter in S4. We performed DEB-TACE using HepaSphere(®) and epirubicin. DEB-TACE was repeated three times in three months. Severe postembolization syndrome was not seen with any treatment. Four weeks after the last DEB-TACE, we performed surgical resection. Histopathological study revealed dense distribution of numerous bead particles in necrotic tumor tissue. Otherwise, in non-cancerous tissue, some beads were in portal areas, without necrotic change. Granulomas from foreign body reaction with giant cells were present around the beads. There were no necrotic changes in the smaller HCC, the intrahepatic metastatic nodules, or the microscopic invasion to the portal vein. In conclusion, DEB-TACE would be a useful treatment for huge HCCs; however, patients should be monitored for early recurrence from residual tumor tissue. This study will be helpful to perform DEB-TACE in the future.
Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital.
Atsuyuki
A
Ikeda
Yumiko
Y
Yasuhara
Daizen
D
Hirata
Mari
M
Teramura
Takeharu
T
Nakamura
Yoko
Y
Oiwa
Osamu
O
Araki
Hidemasa
H
Azechi
Ryuta
R
Nishitai
Hiroyuki
H
Kokuryu
D000368:Aged; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D008297:Male; D009389:Neovascularization, Pathologic; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome