Alharbi SR. Tumor calcification and sustained complete response after chemoembolization in hepatocellular carcinoma: Two case reports and review of literature. World J Gastrointest Oncol 2025; 17(12): 113341 [DOI: 10.4251/wjgo.v17.i12.113341]
Corresponding Author of This Article
Sultan R Alharbi, MD, Associate Professor, Interventional Radiology Unit/Department of Radiology and Medical Imaging, College of Medicine, King Saud University, PO Box 7805, King Abdullah Street, Riyadh 11362, Saudi Arabia. drsultan000@gmail.com
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Gastroenterology & Hepatology
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 15, 2025 (publication date) through Dec 14, 2025
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World Journal of Gastrointestinal Oncology
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1948-5204
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Alharbi SR. Tumor calcification and sustained complete response after chemoembolization in hepatocellular carcinoma: Two case reports and review of literature. World J Gastrointest Oncol 2025; 17(12): 113341 [DOI: 10.4251/wjgo.v17.i12.113341]
World J Gastrointest Oncol. Dec 15, 2025; 17(12): 113341 Published online Dec 15, 2025. doi: 10.4251/wjgo.v17.i12.113341
Tumor calcification and sustained complete response after chemoembolization in hepatocellular carcinoma: Two case reports and review of literature
Sultan R Alharbi
Sultan R Alharbi, Interventional Radiology Unit/Department of Radiology and Medical Imaging, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia
Author contributions: Alharbi SR designed the research study, performed the procedures, analyzed the data, wrote the manuscript, and approved the final version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: The author declares that he has no conflicts of interest to disclosure.
CARE Checklist (2016) statement: The author has read the CARE Checklist (2016) and the manuscript was prepared and revised according to CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sultan R Alharbi, MD, Associate Professor, Interventional Radiology Unit/Department of Radiology and Medical Imaging, College of Medicine, King Saud University, PO Box 7805, King Abdullah Street, Riyadh 11362, Saudi Arabia. drsultan000@gmail.com
Received: August 22, 2025 Revised: September 22, 2025 Accepted: October 13, 2025 Published online: December 15, 2025 Processing time: 111 Days and 10.2 Hours
Abstract
BACKGROUND
Transarterial chemoembolization (TACE) is a widely accepted palliative therapy modality for unresectable hepatocellular carcinoma (HCC). Although it is rarely curative, complete radiological response can be achieved in selected patients, leading to prolonged survival. Post-treatment tumoral calcification is an uncommon imaging finding in HCC and is rarely reported after drug-eluting beads TACE (DEB-TACE).
CASE SUMMARY
Two patients with large, solitary HCCs (> 5 cm) were treated with DEB-TACE, and both achieved complete radiological response after two treatment sessions. Approximately 1 year after DEB-TACE, imaging demonstrated progressive peripheral tumoral calcification. Over 6 years of follow-up, both patients remained in remission with preserved liver function.
CONCLUSION
These two cases highlight the potential for complete remission and long-term survival in selected patients with large HCC following DEB-TACE. The appearance of peripheral calcification may represent a late imaging marker of effective tumor necrosis and durable treatment response although prospective studies are warranted to clarify its prognostic value.
Core Tip: Tumoral calcification following transarterial chemoembolization (TACE) for hepatocellular carcinoma is a rare imaging finding, and its clinical significance remains unclear. This case report describes 2 patients with large hepatocellular carcinoma who developed complete radiological response after drug-eluting beads TACE, followed by progressive peripheral calcification and sustained disease-free survival for 6 years. The notable association between post-TACE calcification and long-term remission raises the possibility that calcification may serve as a late imaging biomarker of effective tumor necrosis and durable treatment response.
