Journal of Liver Cancer

Case Reports

A Case of Atypicial Finding on Follow-up CT after TACE with Doxorubicin-eluting-beads (DEB): Jang Won Park, Gang Mo Kim; Journal of the Korean Liver Cancer Study Group. 2012;12(2):164-168. Published online September 30, 2012

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Abstract PDF: Hepatocellular carcinoma is the sixth most common cancer and the third leading cause of cancer-ralated death. TACE is an effective option for patients with intermediate HCC. Although conventional TACE with administration of a Lipiodo-anticancer emulsion followed by embolic agents has been most popular technique, the recent introduction of embolic DEB has provided a valuable alternative. The DEB is a novel drug delivery embolization system that hea been designed to deliver a higher and more sustained release of drug directly into the tumor and a low release of drug into the systemic circulation, with the intention to maximize the drug effectiveness in terms of response, while significantly reducing its systemic toxicity. Obtaining a triple-phase CT or MRI imaging of the liver is required to integrate clinical and laboratory data to evaluate the indication to TACE with DEB and additional imaging to exclude extrahepatic disease should be performed as pretreatment imaging. Obtaining a CT or MRI imaging 2-4 weeks after TACE is recommend to assess tumor response and to decide the further plan. The use of modified Response Evaluation Criteria in Solid Tumors (mRECIST) for HCC is recommended for response Classification. We offer our experience of a patient with atypical finindg on follow-up CT after DEB TACE. Marginal recurrence or residual viable tumor was suspected on CT 4 weeks after DEB TACE but disappeared on CT 10 weeks after treatment. There was no evidence of recurrence or residual tumor in TACE site and its margin 12 weeks after TACE. We thought that it was attributed to the benign change as AV shunt or to the characteristics of DEB which has been designed to deliver slowly, higher and more sustained release of drug directly into the tumor. But further study is necessary on how long the drug delivery from DEB to tumor is sustained and when the appropriate tumor response is accomplished after treatment.

A Case of Aggressive Treatment with Transarterial Embolization Using Drug-Eluting Beads for Hepatocellular Carcinoma in Decompensated Liver Cirrhosis Patient: Eileen L. Yoon, Hyung Joon Yim, Hwan Hoon Chung, Seung Hwa Lee, Hae Rim Kim, Jong Jin Hyun, Sung Woo Jung, Ja Seol Koo, Sang Woo Lee, Jai Hyun Choi; Journal of the Korean Liver Cancer Study Group. 2011;11(2):190-194. Published online September 30, 2011

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Abstract PDF: Conventional transarterical chemoembolization (TACE) is the first-line treatment for patients with intermediate stage of hepatocellular carcinoma (HCC). However, irreversible liver failure after the procedure is one of the most feared complications and therefore, decompensated Child-Pugh C patients may not be the indication of the conventional TACE. Drug-eluting beads loaded with doxorubicin is a novel drug delivery embolization system and reported to have non inferior efficacy compared to conventional TACE. Also drug-eluting beads loaded with doxorubicin is associated with lower rates of acute liver failure after the procedure and lower rates of systemic toxicity of the chemotherapeutic agents. Herein, we report a case of aggressive treatment with transarterial embolization using drug-eluting beads loaded with doxorubicin for HCC in decompensated liver cirrhosis patient who was not eligible for conventional TACE treatment.

Hepatocellular Carcinoma Diagnosed with Metastatic Lesion of the Cervical Spine: Chung-Hwa Park, Myeong Jun Song, Hee Yeon Kim, Si Hyun Bae, Seung Kew Yoon, Jong Young Choi; Journal of the Korean Liver Cancer Study Group. 2010;10(1):61-63. Published online June 30, 2010

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Abstract PDF: Bone metastases in hepatocellular carcinoma (HCC) are usually treated with non-operative procedures such as radiotherapy, hormonal therapy, bisphosphonates, or sometimes with surgical procedures. Here we describe a case with 3rd cervical spine metastasis of HCC. A 62-year-old female with liver cirrhosis presented with neck pain. After evaluation, the patient was diagnosed of hepatocellular carcinoma with cervical spine metastasis. The metastatic lesion was treated with tomotherapy while the primary lesion in the liver was treated with transarterial chemoembolization using drug-eluting beads, and the patient is tolerable waiting for the next treatment.

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