Siraj Tanveer H, Tameez Ud Din Asim, Chaudhary Farooq Mohyud Din, Ahmad Sultan, Siddiqui Khaleeq H
Gastroenterology, Nishtar Medical University & Hospital, Multan, PAK.
Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK.
Cureus. 2019 Aug 2;11(8):e5305. doi: 10.7759/cureus.5305.
The prevalence of hepatocellular carcinoma (HCC) is increasing worldwide. Multiple strategies are available for its management including surgical removal, chemotherapeutic drugs, and ablative and chemoembolization procedures. Transarterial chemoembolization (TACE) is currently being used for the unresectable intrahepatic tumor with no vascular invasion or metastasis to other organs. The common adverse effects associated with this technique involve self-limiting fever, vomiting, and abdominal pain. Liver failure is reported in a few cases. In this report, we present a case of 37-year-old HCC patient who experienced rapid progression of tumor following TACE. Our patient came to the Gastroenterology & Hepatology Department, Nishtar Hospital, Multan, with signs concerning acute liver failure within a few months following TACE. On triphasic computed tomography (CT) scan, there was evidence of multiple new infiltrating lesions in both lobes of the liver and portal vein thrombosis, which were not present before TACE procedure. Hence, we made a diagnosis of acute, chronic liver disease due to the rapid intrahepatic progression of HCC. This is a rare side effect of TACE procedure and highlights the significance of proper counseling of the patients undergoing this intervention.
肝细胞癌（HCC）在全球范围内的患病率正在上升。其治疗有多种策略，包括手术切除、化疗药物以及消融和化疗栓塞程序。经动脉化疗栓塞术（TACE）目前用于治疗无血管侵犯或无远处转移的不可切除肝内肿瘤。该技术常见的不良反应包括自限性发热、呕吐和腹痛。少数病例报告出现肝衰竭。在本报告中，我们介绍了一例37岁的HCC患者，其在TACE术后肿瘤迅速进展。我们的患者在TACE术后几个月内，因出现急性肝衰竭的症状来到木尔坦尼什塔尔医院胃肠病学和肝病科就诊。在三相计算机断层扫描（CT）上，可见肝脏两叶有多个新的浸润性病变及门静脉血栓形成，而这些在TACE术前并不存在。因此，我们诊断为HCC肝内快速进展所致的急慢性肝病。这是TACE手术罕见的副作用，凸显了对接受该治疗的患者进行适当咨询的重要性。
