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Complete necrosis of a giant tumor in liver by transcatheter arterial embolization and percutaneous transhepatic portal embolization before liver resection
Authors:Naoko Ishida  Kiyoshi Ishigure  Takuya Watanabe  Akira Fujioka  Yosuke Nakamura  Takehisa Furuta  Yoji Sasaki
Institution:Department of Surgery, Konan Kosei Hospital, Japan.
Abstract:A 67-year-old man admitted for abdominal pain. Abdominal CT showed a liver tumor 14 cm in diameter in the right lobe, and a low density area spreading along the left branch of the Glisson's sheath. Serum protein induced by vitamin K absence or antagonist-II (PIVKA-II) level was found extremely high. Transcatheter arterial embolization (TAE) was performed three times, resulting the lesion reduced to 7cm in diameter. As the last TAE showed little effectiveness, we planed to percutaneous transhepatic portal embolization (PTPE) followed by extended right hepatectomy. After PTPE, PIVKA-II was normalized. Histologically, complete necrosis of the tumor lesions was observed in the resected liver.
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