- A Case of Emergent Treatment for Hemodynamic Unstable Patient with Ruptured Hepatocellular Carcinoma
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Jae Keun Kim, Joon Seong Park, Ja Kyung Kim, Hyo Jun Lee, Kwang Hoon Lee, Kwan Sik Lee, Dong Sup Yoon
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Journal of the Korean Liver Cancer Study Group. 2012;12(2):160-163. Published online September 30, 2012
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Abstract
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- A ruptured Hepatocellular carcinoma (HCC) is one of life threatening complication and considered as poor prognosis.
Hemodynamic stability is a key to the early period survival. Hemostasis can be achieved with transarterial embolization and
explo‐laparotomy or surgical resection. Prognosis is related to hemodynamic stability and liver function and tumor size. Surgical
resection of ruptured HCC is recommended when it is possible. Further studies are needed for the treatment of recurred and
progressive patients with ruptured HCC.
- A Case of Advanced Hepatocellular Carcinoma which was Supervening with Renal Cell Cancer Cured by Repeated Transarterial Chemoembolization and Sorafenib after Resection
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Bun Kim, Jae Hoon Min, Seung Up Kim, Jun Yong Park, Kwang Hoon Lee, Do Youn Lee, Jin Sub Choi, Young Deuk Choi, Nam Hoon Cho, Young Nyun Park, Sang Hoon Ahn, Kwang Hyub Han, Chae Yoon Chon, Do Young Kim
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Journal of the Korean Liver Cancer Study Group. 2012;12(1):51-57. Published online February 28, 2012
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Abstract
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- Advanced hepatocellular carcinoma (HCC) is difficult to treat and the survival is poor. Here, we present a patient diagnosed as
advanced HCC (stage IIIa) which was supervening with early renal cell cancer (stage I). The patient was treated with
pre-operational transarterial chemoembolization (TACE) and surgical resection (right hepatectomy, right nephrectomy, and
cholecystectomy). Sorafenib were taken continually after surgery. Multiple recurred HCC nodules in remnant liver were detected
2 months later after surgery. Combined treatment modalities including 4 sessions of TACE, and 12 cycles of 5-flurouracil
(FU)/carboplatin based hepatic arterial infusional chemotherapy (HAIC) induced complete response. After the diagnosis of
advanced HCC, the patient survived 36 months and experienced disease-free status for 19 months.
- A Case of Hepatocellular Carcinoma Recurred Extensively during Treatment of Biliary Complication Occurring after Transarterial Chemoembolization
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Hyun Jung Oh, Hana Park, Kwang Hoon Lee, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Chae Yoon Chon, Jun Yong Park
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Journal of the Korean Liver Cancer Study Group. 2011;11(2):178-184. Published online September 30, 2011
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Abstract
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- Hepatocellular carcinoma(HCC) is one of the cancers with poor prognosis. Transarterial chemoembolization(TACE) has been
widely used for treating unresectable HCC. Although TACE is considered as a less invasive and relative safe procedure, severe
complications such as hepatic failure, pulmonary embolism, liver abscess, biloma formationcan occur rarely after TACE. These
complications sometimes may lead to fatal clinical situation, even death. We reported a case of HCC recurred extensively during
treatment of biliary complication after TACE. A 44-year-old male with HCC was admitted due to fever for 3 days after
undergoing TACE. Three weeks before the admission, he had been diagnosed with HCC recurrence which presented as two
arterial enhancing nodules in MRI and treated with TACE. CT scan showed 7 cm sized air containing fluid collections with
necrosis suggestive of liver abscess and 15 cm sized biloma formation. Because the patient was in septic shock at admission,
percutaneous catheter drainage was performed with use of broad spectrum antibiotics. After treatment of 3 months, the sizes of
hepatic abscess and biloma were remarkably decreased. However, 1 month later, large size tumor recurrence and perihepatic
lymph node metastasis were found on a follow-up CT scan. In this case, the cause of rapid growing recurrence after TACE is
uncertain, but the development of unanticipated complication seems to affect the progression to poor prognosis. Therefore, early
recognization of predisposing factors with proper management would be needed to prevent these serious complications after
TACE.
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