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Transarterial embolization of metastatic mediastinal hepatocellular carcinoma

World Journal of Gastroenterology 2013年第22期19卷 3512-3516页

作者： Chia-Chang Chen Hong-Zen Yeh Chi-Sen Chang chungwang ko Han-Chung Lien Chun-Ying Wu Siu-Wan Hung Department of Gastroenterology and Hepatology Taichung Veterans General Hospital Department of Radiology Taichung Veterans General Hospital

This paper introduces an innovative treatment for extrahepatic metastasis of hepatocellular carcinoma. A 71-yearold patient had a stable liver condition following treatment for hepatocellular carcinoma, but later developed symptomatic mediastinal metastasis. This rapidly growing mediastinal mass induced symptoms including cough and hoarseness. Serial sessions of transarterial embolization (TAE) successfully controlled this mediastinal mass with limited side effects. The patient's survival time since the initial diagnosis of the mediastinal hepatocellular carcinoma was 32 mo, significantly longer than the 12 mo mean survival period of patients with similar diagnoses: metastatic hepatocellular carcinoma and a liver condition with a Child-Pugh class A score. Currently, oral sorafenib is the treatment of choice for metastatic hepatocellular carcinoma. Recentstudies indicate that locoregional treatment of extrahepatic metastasis of hepatocellular carcinomas might also significantly improve the prognosis in patients with their primary hepatic lesions under control. Many effective locoregional therapies for extrahepatic metastasis, including radiation and surgical resection, may provide palliative effects for hepatocellular carcinoma-associated mediastinal metastasis. This case report demonstrates that TAE of metastatic mediastinal hepatocellular carcinoma provided this patient with tumor control and increased survival time. This finding is important as it can potentially provide an alternative treatment option for patients with similar symptoms and diagnoses.

关键词： Embolization Hepatocellular carcinoma Lymphatic metastasis Endosonography Mediastinal neoplasm

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