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9 "Transcatheter arterial chemoembolization"
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Case Report
Two Cases of Spontaneous Bacterial Peritonitis Developed Right after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma
Jung Hoon Lee, Joo Hyun Sohn, Tae Yeob Kim, Ji Young Lee, Ki Sul Chang, Dong Hoon Lee, Eun Sik Park
Journal of the Korean Liver Cancer Study Group. 2013;13(2):145-151.   Published online September 30, 2013
DOI: https://doi.org/10.17998/jlc.13.2.145
  • 1,877 Views
  • 6 Downloads
AbstractAbstract PDF
Although acute hepatic failure (AHF) after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) is not a rare complication, the development of spontaneous bacterial peritonitis (SBP) is uncommon. We describe two cases who suffered SBP and AHF right after TACE for HCCs. In the first case, 5 days after TACE ascites and jaundice newly developed and SBP was diagnosed at 9 days after TACE. After use of secondary antibiotics (imipenam) due to failure of primary therapy with 3rd cephalosporin, he discharged with resolution of SBP. In the second case, jaundice, abdominal pain and fever developed with increased ascites 3 days after TACE. After 8 days, SBP was diagnosed and treated with imipenam due to primary treatment failure, but clinical course was deteriorated. Eighteen days after discharge, she died of AHF. In patients with increased ascites and fever after TACE, clinician should be considered SBP with AHF among post-TACE complications, and prompt management is needed.
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Review Article
Complications Associated with Transcatheter Arterial Chemoembolization in Patients with Hepatocellular Carcinoma
Sun Hong Yoo, Si Hyun Bae
Journal of the Korean Liver Cancer Study Group. 2011;11(2):144-148.   Published online September 30, 2011
  • 803 Views
  • 48 Downloads
AbstractAbstract PDF
Transcatheter arterial chemoembolization (TACE) is one of the most effective treatments for patients with inoperable hepatocellular carcinoma (HCC). However, variable complications can occur after TACE. Complications resulting from TACE contain postembolization syndrome, liver abscess, bile duct injury, ruptured HCC, acute hepatic failure, variceal bleeding, acute kidney injury, pulmonary lipiodol embolization, femoral artery pseudoaneurysm, femoral arteriovenous fistula, abdominal aortic dissection, spinal cord injury, and others. Complications after TACE are occasionally fatal. Therefore, it is important that we are well acquainted ourselves with these complications, and need care promptly the patient who develop symptoms of complication.
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Case Reports
Conus Medullaris Syndrome after Transcatheter Arterial Chemoembolization in Patient with Hepatocellular Carcinoma
Sun Hong Yoo, Si Hyun Bae, Pil Soo Sung, Hee Yeon Kim, Do Seon Song, Myeong Jun Song, Jong Young Choi, Seung Kew Yoon, Ho Jong Chun
Journal of the Korean Liver Cancer Study Group. 2011;11(2):185-189.   Published online September 30, 2011
  • 766 Views
  • 8 Downloads
AbstractAbstract PDF
Hepatocellular carcinoma (HCC) is the fourth most common cancer in Korea and a common cause of cancer death. Transcatheter arterial chemoembolization (TACE) is used as palliative therapy for patients with inoperable HCC. TACE is an effective treatments for inoperable HCC, but variable complications due to using embolic agents can occur after TACE. Complications due to embolic agents include pulmonary lipiodol embolism, splenic infarction, cerebral lipiodol infarction, and spinal cord injury. This is a rare case of spinal cord injury after a sixth TACE via right T9 intercostal artery.
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Effect of combination therapy with TACE and 3D-CRT for two patients with PVT and/or IVC tumor thrombus
Hyun Deok Shin, Young-Suk Lim, Soon Joo Kim, Sang Hyun Park, Gang Mo Kim, Han Chu Lee, Young Hwa Jung, Young Sang Lee, Dong Jin Suh
Journal of the Korean Liver Cancer Study Group. 2007;7(1):87-93.   Published online June 30, 2007
  • 747 Views
  • 1 Download
AbstractAbstract PDF
Advanced hepatocellular carcinoma has a poor prognosis, especially in the cases with portal vein or IVC tumor thrombi. In such cases, surgical resection could not be a curative treatment option and transcatheter arterial chemoembolization (TACE) alone is usually ineffective. Recently, three-dimensional conformal radiation therapy (3D-CRT) has been developed to better conform the radiation dose to the tumor volume in order to reach the goal of eradicating local disease without injuring normal tissue. Combination therapy with TACE and 3D-CRT could be considered as a treatment option for advanced HCC with PV or IVC tumor thrombi. We report here two cases with advanced HCC showing response to combination therapy with repeated TACE and 3D-CRT.
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A Case of Advanced Hepatocellular Carcinoma : Curative Resection after Repeated Transcatheter Arterial Chemoembolization, Systemic Chemotherapy and Radiotherapy
So Yeon Lee, Seung Kew Yoon, Min Su Kim, Si Hyun Bae, Jong Young Choi, Byung Gil Choi, Ho Jong Chun, Dong Gu Kim, Seok Whan Moon
Journal of the Korean Liver Cancer Study Group. 2006;6(1):38-41.   Published online June 30, 2006
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AbstractAbstract PDF
A 46 year-old male patient was admitted to our hospital for evaluation of hepatic mass which was detected on ultrasonography. He had a history of chronic hepatitis B carrier. Laboratory findings showed that HBsAg was positive, and HBeAg was negative. AFP was 2,081.1 ng/mL. Abdomen CT showed a large well-defined low density lesion involving entire right hepatic lobe which was compatable with advanced hepatocellular carcinoma (stage III). Celiac and hepatic arteriogram reveled huge hypervascular mass at both lobe of the liver. Transcatheter arterial chemoembolization (TACE), systemic chemotherapy, percutaneous ethanol injection therapy (PEIT), and radiotherapy were combined as the treatment of huge hepatoma. After combined therapy, tumor decreased in size. As a result, curative right lobectomy could be performed. Six months after surgery, chest CT showed two small metastatic nodules in both lung, so wedge resection was performed. We followed the patient for 5 years after operation and there was no evidence of regional tumor recurrence or distant metastasis.
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Successful Resection of Modified UICC stage Ⅳa Hepatocellular Carcinoma after Arterial Chemoembolization & Radiation Therapy: A Case Report
Min An, Joong-Won Park, Jung A Shin, Tae Hyun Kim, Seong-Hoon Kim, Sang-Jae Park, Woo Jin Lee, Eun Kyung Hong, Chang-Min Kim
Journal of the Korean Liver Cancer Study Group. 2006;6(1):56-59.   Published online June 30, 2006
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  • 1 Download
AbstractAbstract PDF
Surgical resection is not candidate for advanced stage hepatocellular cacinoma with portal vein thrombosis, but transcatheter arterial chemoembolization (TACE) or radiotherapy can be considered as palliative treatment option. We experienced a 44-old-male who has stage Ⅳa hepatocellular carcinoma. We performed TACE and 3-dimensional conformal radiotherapy for hepatocellular carcinoma and portal vein thrombosis. Because follow up image study showed no viable tumor, we then performed surgical resection. Surgical specimen also showed complete tumor necrosis.
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Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma with Arterioportal Shunt : A Report of One Case
Sang Kyun Yu, Soon Ho Um, Cheol Young Kim, Sung Bum Cho, Nam Hee Won
Journal of the Korean Liver Cancer Study Group. 2004;4(1):29-32.   Published online June 30, 2004
  • 770 Views
  • 9 Downloads
AbstractAbstract PDF
Transcatheter arterial chemoembolization(TACE) is an effective treatment method in the management of patients with inoperable hepatocellular carcinoma. The effectiveness of TACE, however, is decreased, when arterioportal shunt is present, since embolic and chemotherapeutic agents are diverted from the tumor to the normal parenchyma through branches of the portal vein. In such case, TACE may not only be ineffective, but also cause hepatic infarction followed by hepatic failure. We report a case of hepatocellular carcinoma with arterioportal shunt, successfully treated by TACE.
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A Case of Early Recurrence of Hepatocellular Carcinoma after Curative Hepatic Resection
Sang-Hyung Cho, Jae-Hee Cheon, Hong-Suk Park, Seong-Hoon Kim, Sang-Jae Park, Woo-Jin Lee, Eun-Kyung Hong, Joong-Won Park, Chang-Min Kim
Journal of the Korean Liver Cancer Study Group. 2004;4(1):55-58.   Published online June 30, 2004
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AbstractAbstract PDF
A 52-year-old male was referred to our hospital for further evaluation and treatment of known hepatocelluar carcinoma. He did not have risk factors for hepatocellular carcinoma, such as hepatitis virus infection, alcohol abuse and occupational history. We performed CT scan that showed a single nodule with a diameter of 4 cm in the segment Ⅴ. MR imaging showed the same nodule in the segment Ⅴ without any additional nodule in the liver. We performed segmentectomy for the segment Ⅴ, Ⅵ, and Ⅶ. Five months later, follow-up CT scan showed disseminated hypervascular nodules involving the remaining liver. Hepatic angiography also showed multiple hypervascular nodules in the remaining liver, indicating early recurrence by intrahepatic metastasis. We then performed transcatheter arterial chemoembolization (TACE). At present, this patient underwent TACE for ten times, but was still found to have new intrahepatic metastases, tumor invasion to the portal vein and lymph node metastasis in the peripancreatic area.
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An Ischemic Skin Lesion after Chemoembolization of the Right Internal Mammary Artery in a Patient with Hepatocellular Carcinoma
Jae-Hoon Lee, Chae Yoon Chon, Yong-Han Paik, Kwang-Hyub Han, Jong Tae Lee, Do Yun Lee, Young Myoung Moon
Journal of the Korean Liver Cancer Study Group. 2001;1(1):133-136.   Published online June 30, 2001
  • 605 Views
  • 4 Downloads
AbstractAbstract PDF
A large nodular hepatocellular carcinoma located at the anterior superior portion of the left lobe was treated with transcatheter arterial chemoembolization through the left hepatic artery. Three months later, however, there was a re-elevation of the serum alpha-fetoprotein level and an evidence of a marginal recurrence at the left side of the previously embolized tumor was noted on the postembolizeation computed tomographic scan. Although the hepatic artery was intact in the second hepatic arteriography, we found that the right internal mammary artery was feeding the recurred hepatocellular carcinoma. Right internal mammary artery was successfully treated with Lipiodol-transcatheter arterial chemoembolization. However, an ischemic lesion occurred in the skin of the anterior chest and abdominal wall several days after the embolization of the internal mammary artery. We report here a very rare case of ischemic skin lesion on the anterior chest and abdominal wall following transcatheter arterial chemoembolization of the right internal mammary artery. This internal mammary artery was embolized because it had developed a collateral tumor feeding vessel following the initial chemoembolization of a hepatocellular carcinoma.
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