Case Report
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Aug 28, 2007; 13(32): 4398-4400
Published online Aug 28, 2007. doi: 10.3748/wjg.v13.i32.4398
Successful treatment of hypovascular advanced hepatocellular carcinoma with lipiodol-targetting intervention radiology
Kazutaka Kurokohchi, Akihiro Deguchi, Tsutomu Masaki, Takashi Himoto, Hirohito Yoneyama, Mitsuyoshi Kobayashi, Tsuyoshi Maeta, Takaaki Kiuchi, Fumikazu Kohi, Hisaaki Miyoshi, Tomohiko Taminato, Shigeki Kuriyama
Kazutaka Kurokohchi, Akihiro Deguchi, Tsutomu Masaki, Takashi Himoto, Hirohito Yoneyama, Mitsuyoshi Kobayashi, Hisaaki Miyoshi, Shigeki Kuriyama, Department of Gastroenterology and Neurology, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan
Kazutaka Kurokohchi, Tomohiko Taminato, Department of Laboratory Medicine, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan
Tsuyoshi Maeta, Fumikazu Kohi, Department of Gastroenterology, KKR Takamatsu Hospital, 4-18 Tenjinmae, Takamatsu, Kagawa 760-0018, Japan
Takaaki Kiuchi, Department of Radiology, KKR Takamatsu Hospital, 4-18 Tenjinmae, Takamatsu, Kagawa 760-0018, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Kazutaka Kurokohchi, Department of Gastroenterology and Neurology, Kagawa University School of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. kuroko@med.kagawa-u.ac.jp
Telephone: +81-87-8912156 Fax: +81-87-8912158
Received: April 19, 2007
Revised: May 15, 2007
Accepted: May 21, 2007
Published online: August 28, 2007
Abstract

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.

Keywords: Hypovascular hepatocellular carcinoma; Percutaneous ethanol-lipiodol injection therapy; Inter-vention radiology