Chang Wook Park, Young Lan Kown, Yong Jin Kim, Yoon Jung Kim, Hye Jin Seo, Kyung In Lee, Eun Soo Kim, Byung Kook Jang, Woo Jin Jeong, Kyung Sik Park, Kwang Bum Jo, Jae Seok Hwang, Young Hwan Kim, Jung Hyuk Kwon
Journal of the Korean Liver Cancer Study Group. 2010;10(1):40-43. Published online June 30, 2010
Hepatocellular carcinoma (HCC) is one of the cancers with poor prognosis. Especially potal vein invasion is a grave
prognostic indicator in the setting of HCC. There is currently no effective method for treatment of HCC with portal vein
invasion. A 61-year-old female patient was diagnosed a massive HCCs in both hepatic lobe with portal vein thrombosis,
based on computed tomography (CT) and increased tumor marker, α-fetoprotein. She was treated with intrahepatic arterial
CDDP (10 mg on 1~5 day), 5-FU (250mg on 1~5 day) and leukovorin (12mg on 1~5 day) infusion via percutaneously
implantable port system (PIPS) every 3 weeks, totally seven times. The patient was still living 6 months after first hepatic
arterial infusion chemotherapy (HAIC) and follow-up CT showed partial response with necrosis of HCCs. We report here
a case of advanced HCC with portal vein thrombosis that was effectively treated with HAIC via PIPS.
A 52 year-old-man patient was admitted for evaluation of hepatic mass which was detected on screening ultrasonography.
His abdominal CT showed a massive infiltrating mass in left hepatic lobe and another 2.4 cm nodule in S6 of Rt. Hepatic
lobe with arterial enhancement and rapid wash out underlying liver cirrhosis. Also, low density tumor thrombus are filled
in Lt. portal vein and extended into main portal vein. He was finally diagnosed HCC (UICC stage IVa) with liver cirrhosis
(Child-Pugh class A) and hepatitis B. With the four times of trasnarterial chemo-lipiodolization and seven times of
intraarterial infusion chemotherapy for huge mass and one time Radiofrequency ablation (RFA) for daughter nodule, his HCC
showed no stain in hepatic angiogram at nine month from initial diagnosis. After additional eight times of intra-arterial
infusion chemotherapy, new small nodule developed in S6 and was ablated with RFA. At eighteen months after initial
diagnosis, he shows no viable lesion on the imaging study and tumor markers are normalized.