Imai Yusuke, Hirooka Masashi, Koizumi Yohei, Nakamura Yoshiko, Watanabe Takao, Yoshida Osamu, Tokumoto Yoshio, Takeshita Eiji, Abe Masanori, Tanaka Hiroaki, Kurata Mie, Kitazawa Sohei, Hiasa Yoichi
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan.
Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan.
Radiol Case Rep. 2016 Dec 27;12(1):179-184. doi: 10.1016/j.radcr.2016.11.006. eCollection 2017 Mar.
A 58-year-old man was diagnosed with advanced hepatocellular carcinoma with portal vein tumor thrombosis (PVTT). The tumors were multiple and existed in both lobes. Drug-eluting beads transcatheter arterial chemoembolization (DEB-TACE) was performed for the tumors in the left lobe. Embosphere and Hepasphere were selected for embolization of the arterioportal shunt, followed by loaded epirubicin infusion into the left hepatic artery. Computed tomography showed reduction of PVTT. However, liver failure progressed, and the patient died 67 days after DEB-TACE. Autopsy showed that the beads reached the tumor thrombosis in the portal vein. The prognosis of hepatocellular carcinoma with PVTT is poor. Although there are no established treatments for unresectable PVTT, DEB-TACE might be a useful option for such cases.
一名58岁男性被诊断为晚期肝细胞癌伴门静脉癌栓（PVTT）。肿瘤为多发，存在于两叶。对左叶肿瘤进行了载药微球经动脉化疗栓塞术（DEB-TACE）。选用Embosphere和Hepasphere栓塞动门脉分流，随后将表柔比星注入左肝动脉。计算机断层扫描显示门静脉癌栓缩小。然而，肝功能衰竭进展，患者在DEB-TACE术后67天死亡。尸检显示微球到达门静脉的肿瘤血栓处。伴有PVTT的肝细胞癌预后较差。虽然对于无法切除的PVTT尚无既定的治疗方法，但DEB-TACE可能是此类病例的一种有用选择。
