A case of radiofrequency ablation with hepatic venous balloon occlusion and transient hepatic arterial embolization using degradable starch microspheres for a large well-differentiated hepatocellular carcinoma
Masada, T.; Anai, H.; Sueyoshi, S.; Tanaka, T.; Nishiofuku, H.; Maeda, S.; Sakaguchi, H.; Kichikawa, K.
Gan to Kagaku Ryoho. Cancer and ChemoTherapy 39(12): 1822-1824
2012
ISSN/ISBN: 0385-0684 PMID: 23267898 Document Number: 659250
A 70-year-old man with liver cirrhosis due to hepatitis C viral infection had a single well-differentiated hepatocellular carcinoma(HCC) of 5-cm diameter in the right superior anterior segment of the liver. Surgery could not be performed because of his poor liver function. Furthermore, it was difficult to treat this tumor with transcatheter arterial chemoembolization because the tumor exhibited hypovascularity. Radiofrequency ablation (RFA) alone was also not an option because the tumor was too large to manage with a simple RFA procedure. This solitary tumor was adjacent to the right and middle hepatic veins. Finally, we planned to treat this tumor with RFA and temporary vessel occlusion as follows: RFA was performed with a 5-cm expandable type RITA model 90 electrode under temporary occlusions of the right anterior hepatic artery with degradable starch microspheres, and of the right and middle hepatic veins by balloon catheters, to reduce the heat sink effect and obtain a larger coagulation size. We successfully treated this HCC with RFA combined with temporary vessel occlusion, and the patient has not obtained local recurrence at 18 months of the procedure.