A case of complete remission of advanced hepatocellular carcinoma with type III portal vein tumor thrombosis treated using transarterial chemoembolization with microspheres and radiation therapy
| Autor: | Yoshiki Shiwa, Daizo Fukushima, Ryota Koyanagi, Hideo Sakuma, Kohichi Hamada, Noriyuki Nishino, Hitoshi Wada, Shin'ya Nishida, Shigeki Imai, Yoshinori Horikawa |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Carcinoma Hepatocellular medicine.medical_treatment Standardized uptake value 03 medical and health sciences 0302 clinical medicine Internal medicine Ascites medicine Humans Chemoembolization Therapeutic Venous Thrombosis business.industry Portal Vein Liver Neoplasms Gastroenterology General Medicine Hepatology Middle Aged medicine.disease Thrombosis Microspheres Radiation therapy Treatment Outcome 030220 oncology & carcinogenesis Hepatocellular carcinoma Portal hypertension 030211 gastroenterology & hepatology Female Radiology medicine.symptom business Abdominal surgery |
| Zdroj: | Clinical journal of gastroenterology. 13(5) |
| ISSN: | 1865-7265 |
| Popis: | Portal vein tumor thrombosis (PVTT) is an extremely locally advanced form of hepatocellular carcinoma. The natural median survival time of patients with hepatocellular carcinoma with PVTT is 2.7 to 4.0 months. A 63-year-old woman visited our clinic complaining of abdominal distention and appetite loss, which she had had for 3 weeks prior to admission. A contrast-enhanced computed tomography scan showed double hepatocellular carcinomas with Type III PVTT and massive ascites caused by arterio-portal shunts within the PVTT. The ascites could not be treated by concentrated ascites reinfusion therapy or diuretics. Transarterial embolization using microspheres followed by radiation therapy against PVTT and five courses of transarterial chemoembolization using microspheres and cisplatin led to the maintaining of complete remission of both ascites and tumors for over 12 months after treatment. Fluoroglucose accumulation of PVTT showed 11.2 as a maximum standard uptake value on positron emission tomography before treatment. No fluoroglucose accumulation within PVTT was observed for over 12 months following treatment. Transarterial chemoembolization using microspheres followed by radiation therapy against Type III PVTT may result in drastic anti-cancer effects and improvement of both serum albumin and intractable ascites after treatment of arterio-portal shunts within the PVTT causing portal hypertension. |
| Databáze: | OpenAIRE |
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