Abstract

Here we report a case of multifocal advanced hapatocellular carcinoma successfully treated by repeated transc atheter arterial chemoembolization (TACE), percutaneous ethanol injection (PEI) and surgical resection. Previously healthy 54-year old man was admitted for the evaluation of incidental hepatic masses. Abdominal CT revealed multifocal hepatic masses in right lobe including segment 5, 6 and 8, which showed early wash-out pattern in portal phase and increased serum alpha fetoprotein (>840 ng/mL) was compatible with advanced hepatocelluar carcinoma (stage III). Underlying cirrhosis was noted and Child-Pugh classification was A (5 points). After 4 cycles of TACE, nodular masses in segment 6 and 8 were completely lipiodolized. Viable mass in the remained huge mass in right anterior lobe was treated by surgical resection. After 4 month operation, abdominal CT revealed new hepatoma lesion at right anterior lobe, serum AFP was increased to 61 ng/mL. The lesion was treated by one session of TACE. Underlying chonic hepatitis C was also treated with interferon and ribavirin. The patient has been followed for 9 years without evidence of regional tumor recurrence or distant metastasis.

• Keywords: Hepatocellular carcinoma;Transarterial chemoembolization;Radiofrequency ablation;Combination