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Journal of the Korean Liver Cancer Study 2011;11(2):178-184.
Published online September 30, 2011.
A Case of Hepatocellular Carcinoma Recurred Extensively during Treatment of Biliary Complication Occurring after Transarterial Chemoembolization
Hyun Jung Oh1, Hana Park1, Kwang Hoon Lee1,2, Do Young Kim1,3, Sang Hoon Ahn1,3, Kwang-Hyub Han1,3, Chae Yoon Chon1,3, Jun Yong Park1,3
1Departments of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
2Departments of Radiology, Yonsei University College of Medicine, Seoul, Korea
3Liver Cancer Special Clinic, Severance Hospital, Seoul, Korea
Correspondence:  Jun Yong Park,
Email: drpjy@yuhs.ac
Copyright ©2011 by The Korean Liver Cancer Association
Hepatocellular carcinoma(HCC) is one of the cancers with poor prognosis. Transarterial chemoembolization(TACE) has been widely used for treating unresectable HCC. Although TACE is considered as a less invasive and relative safe procedure, severe complications such as hepatic failure, pulmonary embolism, liver abscess, biloma formationcan occur rarely after TACE. These complications sometimes may lead to fatal clinical situation, even death. We reported a case of HCC recurred extensively during treatment of biliary complication after TACE. A 44-year-old male with HCC was admitted due to fever for 3 days after undergoing TACE. Three weeks before the admission, he had been diagnosed with HCC recurrence which presented as two arterial enhancing nodules in MRI and treated with TACE. CT scan showed 7 cm sized air containing fluid collections with necrosis suggestive of liver abscess and 15 cm sized biloma formation. Because the patient was in septic shock at admission, percutaneous catheter drainage was performed with use of broad spectrum antibiotics. After treatment of 3 months, the sizes of hepatic abscess and biloma were remarkably decreased. However, 1 month later, large size tumor recurrence and perihepatic lymph node metastasis were found on a follow-up CT scan. In this case, the cause of rapid growing recurrence after TACE is uncertain, but the development of unanticipated complication seems to affect the progression to poor prognosis. Therefore, early recognization of predisposing factors with proper management would be needed to prevent these serious complications after TACE.
Key Words: Hepatocellular carcinoma; Transarterial chemoembolization; Biliary complication; Recurrence


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