Open AccessSuccessful treatment of hypovascular advanced hepatocellular carcinoma with lipiodol-targetting intervention radiology
Author(s) -
Kazutaka Kurokohchi,
Akihiro Deguchi,
Tsutomu Masaki,
Takashi Himoto,
Hirohito Yoneyama,
Mitsuyoshi Kobayashi,
Tsuyoshi Maeta,
Takaaki Kiuchi,
Fumikazu Kohi,
Hisaaki Miyoshi,
Tomohiko Taminato,
Shigeki Kuriyama
Publication year - 2007
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v13.i32.4398
Subject(s) - lipiodol , hepatocellular carcinoma , medicine , radiology , nuclear medicine
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.