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经动脉化疗栓塞术治疗肝细胞癌的一种罕见并发症;假性动脉瘤:病例报告。

An Unusual Complication of Transarterial Chemoembolization of Hepatocellular Carcinoma; Pseudoaneurysm: A Case Report.

机构信息

Department of Radiology, Bagcilar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.

出版信息

Curr Med Imaging. 2022;18(11):1244-1247. doi: 10.2174/1573405618666220325101911.

Abstract

BACKGROUND

Transarterial chemoembolization (TACE) is a globally recognised treatment method for hepatic tumors, especially unresectable hepatocellular carcinoma (HCC). Although the technique is relatively safe, it may cause serious complications, such as liver abscess, liver failure, and non-target embolization. Here, the case of a rare complication of TACE is presented.

CASE PRESENTATION

A-55-year-old male patient was referred to the interventional radiology department for surgically unresectable HCC. CT scan showed a heterogeneously enhancing lesion with capsular enhancement consistent with HCC. On MRI examination, a central necrotic part was seen within the lesion, and TACE was performed. At the end of the TACE, a pseudoaneurysm of the hepatic artery was detected, which was successfully embolized with pushable micro-coils.

CONCLUSION

To the best of our knowledge, very few cases of pseudoaneurysm of the hepatic artery have been described in the literature, and in those cases, the cause has been thought to be guidewire manipulation. In contrast, in the current case, it was thought that it might occur due to central necrosis and central perfusion insufficiency of the lesion. Pseudoaneurysm is a treatable condition with coil embolization.

摘要

背景

经动脉化疗栓塞术(TACE)是一种全球认可的治疗肝肿瘤的方法,特别是不可切除的肝细胞癌(HCC)。尽管该技术相对安全,但可能会引起严重并发症,如肝脓肿、肝功能衰竭和非靶栓塞。本文报告了 TACE 罕见并发症的病例。

病例介绍

一名 55 岁男性患者因手术不可切除的 HCC 被转至介入放射科。CT 扫描显示病变呈不均匀增强,伴有包膜增强,符合 HCC。MRI 检查显示病变内有中央坏死区,行 TACE 治疗。TACE 结束时,发现肝动脉假性动脉瘤,成功用可推送微弹簧圈栓塞。

结论

据我们所知,文献中很少有肝动脉假性动脉瘤的病例报道,这些病例的病因被认为是导丝操作。相比之下,在当前病例中,我们认为可能是由于病变的中央坏死和中央灌注不足导致的。假性动脉瘤可以通过线圈栓塞治疗。

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