Infiltrative hepatocellular carcinoma (HCC) patients have a poor prognosis because most
patients present with advanced disease. Although tumor size is small, ablation therapy
is difficult because it is difficult to delineate tumor boundary and tumor often combined
vascular invasion. Therefore many clinicians still try locoregional therapy (LRT) such as
transarterial chemoembolization (TACE), radiation therapy (RT), or combination with LRT
and sorafenib in this situation. Stereotactic body radiation therapy (SBRT) is new technology
providing very highly conformal ablative radiation dose and is expected to salvage modality
for HCC showed incomplete response of TACE due to combined arteriovenous (AV) shunts.
Based on above suggestions, we herein offer our experience of a complete remission of tumor
by combination of SBRT and TACE in a patient with infiltrative HCC. Further study, maybe
regarding a combination of locoregional and systemic therapy is necessary on how to manage
infiltrative HCC with AV shunts.