Two cases of recurrent hepatocellular carcinoma that progressed rapidly in an unusual manner after radiofrequency ablation combined with transcatheter arterial infusion chemotherapy

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  • Fushiya Nao
    Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
  • Masui Yoshifumi
    Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
  • Onoda Hiroshi
    Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
  • Murakami Shigeto
    Division of Gastroenterology and Hepatology, The Jikei University Daisan Hospital
  • Nakajima Hisato
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine
  • Tajiri Hisao
    Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine

Bibliographic Information

Other Title
  • 肝動脈化学療法併用ラジオ波焼灼療法後，特異な再発様式で急速な進展を呈した肝細胞癌の２症例
  • 症例報告 肝動脈化学療法併用ラジオ波焼灼療法後,特異な再発様式で急速な進展を呈した肝細胞癌の2症例
  • ショウレイ ホウコク キモ ドウミャク カガク リョウホウ ヘイヨウ ラジオハ ショウシャク リョウホウ ゴ,トクイ ナ サイハツ ヨウシキ デ キュウソク ナ シンテン オ テイシタ キモ サイボウガン ノ 2 ショウレイ

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Description

Case 1 was a 78 year-old man with alcoholic liver damage, hepatocellular carcinoma (HCC) showed a suspicious tumor in the region of 30 mm diameter segment 5/8 of the liver, but its tumor on CT and MRI images was atypical HCC, was close to the portal vein and hepatic vein. His laboratory data showed an increase in lens culinaris agglutinin A-reactive alpha-fetoprotein (AFP-L3) and protein induced by vitamin K antagonist-II (PIVKA-II). This tumor has been diagnosed with HCC by abdominal angiography, will be preceded by lipiodol-transcatheter arterial infusion chemotherapy (Lip-TAI), underwent radiofrequency ablation therapy (RFA) and percutaneous ethanol injection therapy (PEIT). This tumor exacervated showing a tumor thrombosis in the right portal vein anterior branch after 4 months. This tumor spread gradually that he passed away after 9 months.<br> Case 2 was a 67 year-old man with liver cirrhosis due to hepatitis C virus and alcohol, HCC detected a tumor in the region of 30 mm diameter segment 6 of the liver, and its tumor on CT image was unclear boundaries, was close to the right portal vein posterior-inferior branch. He had elevated alpha-fetoprotein and AFP-L3 and PIVKA-II. This tumor were treated with Lip-TAI, underwent RFA. This tumor was rapid progress showing a tumor thrombosis in the right portal vein anterior and posterior branch after 4 months. He occurred to a rupture of esophageal varices after 7 months, in the aftermath progressed liver failure, and his death 9 months later. Treatment of HCC is important to understand in detail the nature of the tumor and localization by utilizing the history of tumor markers and various imaging, to determine the therapeutic strategy whether internal or surgical therapy to guess the grade of the tumor, histological degree of differentiation and macroscopic type and the possibility of vascular invasion.<br>

Journal

  • Kanzo

    Kanzo 52 (11), 732-744, 2011

    The Japan Society of Hepatology

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