Korean J Hepatol.  2009 Mar;15(1):90-95. 10.3350/kjhep.2009.15.1.90.

A case of advanced hepatocellular carcinoma with portal vein tumor invasion controlled by percutaneous ethanol injection therapy

• Yoon I
• Yim HJ
• Kim JN
• Park SM
• Kim JH
• Lee SH
• Chung HH
• Lee HS
• Lee SW
• Choi JH

• KMID: 1776819
• DOI: http://doi.org/10.3350/kjhep.2009.15.1.90

Abstract

Portal vein invasion is a grave prognostic indicator in the setting of hepatocellular carcinoma (HCC). There is currently no effective method for preventing the invasion of HCC into the main portal vein. We report here a case of advanced HCC with portal vein tumor thrombosis that was effectively treated with percutaneous ethanol injection (PEI), having previously enabled subsequent successive transarterial chemoembolization (TACE). A 60-year-old male patient was diagnosed with a huge HCC, based on computed tomography and angiographic findings. Despite two sessions of TACE, the tumor invaded the right portal vein. PEI was performed on the malignant portal vein thrombosis, and three sessions thereof reduced the extent of tumor thrombi in the portal vein. Successive TACEs were performed to treat the HCC in the hepatic parenchyma. The patient was still living 19 months after the first PEI with no evidence of tumor recurrence, and his liver function remained well preserved.

Keyword

Carcinoma, Hepatocellular; Portal vein tumor thrombosis; Transarterial chemoembolization; Percutaneous ethanol injection therapy

MeSH Terms

Carcinoma, Hepatocellular/complications/*diagnosis/pathology
Chemoembolization, Therapeutic
Ethanol/*administration & dosage
Humans
Injections, Intralesional
Liver Neoplasms/complications/*diagnosis/pathology
Male
Middle Aged
Neoplasm Invasiveness
*Portal Vein/pathology
Tomography, X-Ray Computed
Venous Thrombosis/complications/diagnosis/*therapy