Abstract

A 44 year-old-male patient was admitted to our hospital for evaluation of hepatic mass which was detected on ultrasonography. On serologic and tumor marker study, HBeAg was positive, AFP was 570 mg/mL. Liver function test was normal. Abdomen CT showed less enhanced hepatic mass on 4, 5 and left portal vein thrombosis. Hepatocellular carcinoma was confirmed with biopsy and we treated the patient with transarterial chemoembolization (TACE). CT scan taken 2 weeks after TACE showed the aggravation of portal vein thrombosis and Lipiodol was washed out. After 1 month after TACE, we could not perform any more TACE because portogram showed both portal veins were occluded. CT showed new mass on S 6. We inserted chemoport catheter to proper hepatic artery and started intra-arterial chemotherapy(5-FU 250 mg and cisplatin 10 increased. But after the 2nd cycle of IACT, tumor size was decreased and after the 3rd cycle tumor on S 6 was disappeared. After the 4th cycle, tumor on S 4, 5 was disappeared. We have tried totally 6 cycles of IACT　and CT taken after the 6th IACT showed no tumor mass and no portal vein thrombosis. Serum AFP level was rapidly dropped and remained less than 2.0 ng/dL after the 4th cycle. We followed the patient for 14 months after the 6th cycle and there was no evidence of residual tumor with image and tumor marker study.

• Keywords: Hepatocellular carcinoma;Intra-arterial chemotherapy