This is the case of a 57 year-old man, with a hepatocellular
carcinoma on HBV-related cirrhosis. He was completely asymptomatic.
During the usual follow-up for cirrhosis, hepatic ultrasound showed
a hyperecogen nodule in the segment 2 and 3. Abdominal CT-scan confirmed
a 5 cm tumor of the left lobe close to the confluence of the left
hepatic vein to the vena cava, with a complete peritumoral capsula.
CT also showed the presence of three symple cysts, one in the segment
4 and two in the right liver along the right hepatic vein. Biopsy
of the tumor made the diagnosis of a well differentiated hepatocellular
carcinoma. The patient was classified as Class A of the Child-Pugh
Classification. Serum alphafetoprotein levels were normal.
Before surgical resection he was subjected to trans-arterial chemoembolization
(TACE); the angiography, in the diagnostic phase, showed the hypervascularized
lesion in the left lobe of the liver (fig 1). Chembolization was
performed using Lipiodol, Carboplatinum (450 mg) and Gelfoam powder.
After the procedure neoplastic vascular circulation was completely
disappeared (fig 2). |
