Delayed Intratumoral Hemorrhage after Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma
Transarterial chemoembolization (TACE) using a drug-eluting bead (DEB-TACE) for hepatocellular carcinoma (HCC) is a new treatment method. We report on a case of delayed intratumoral hemorrhage after DEB-TACE. An 81-year-old male with hepatitis C virus-related cirrhosis was diagnosed with a HCC of 35...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2014-11-01
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| Series: | Case Reports in Oncology |
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| Online Access: | http://www.karger.com/Article/FullText/369005 |
| _version_ | 1828850603841814528 |
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| author | Kazue Shiozawa Manabu Watanabe Takashi Ikehara Yu Ogino Tomoko Umakoshi Yasushi Matsukiyo Michio Kogame Teppei Matsui Yoshinori Kikuchi Yoshinori Igarashi Yasukiyo Sumino |
| author_facet | Kazue Shiozawa Manabu Watanabe Takashi Ikehara Yu Ogino Tomoko Umakoshi Yasushi Matsukiyo Michio Kogame Teppei Matsui Yoshinori Kikuchi Yoshinori Igarashi Yasukiyo Sumino |
| author_sort | Kazue Shiozawa |
| collection | DOAJ |
| description | Transarterial chemoembolization (TACE) using a drug-eluting bead (DEB-TACE) for hepatocellular carcinoma (HCC) is a new treatment method. We report on a case of delayed intratumoral hemorrhage after DEB-TACE. An 81-year-old male with hepatitis C virus-related cirrhosis was diagnosed with a HCC of 35 mm in diameter in S5 detected by dynamic computed tomography (CT) and contrast-enhanced ultrasonography (CEUS). DEB-TACE with DC Bead® and epirubicin hydrochloride was performed because the patient declined to undergo surgical resection. The treatment was completed, and the course after DEB-TACE was favorable. However, right hypochondriac pain suddenly developed about 1 month after DEB-TACE. Unenhanced CT showed an increase of the tumor diameter and intratumoral high-intensity area, which was not enhanced in the arterial phase. CEUS performed at the time of right hypochondriac pain (5 weeks after DEB-TACE) showed nonenhancement of almost the entire tumor in the vascular phase. The cause of the symptom may have been DEB-TACE-associated intratumoral hemorrhage. Tumor hemorrhage has been reported after DEB-TACE with tumors >5 cm in diameter, and the tumor locations were subcapsular in all previous reports. There has been no case of a tumor with a diameter <5 cm distinct from the subcapsular, as was observed in our patient. Incomplete embolization might be the cause of the intratumoral hemorrhage experienced by this case presenting a few risks. To obtain the therapeutic effect of DEB-TACE while preventing the adverse events, it may be important to understand the characteristics of the beads and to apply the appropriate embolization to each individual case. |
| first_indexed | 2024-12-12T23:15:22Z |
| format | Article |
| id | doaj.art-a2c3d35e96c342bca8bb9ad2b888455c |
| institution | Directory Open Access Journal |
| issn | 1662-6575 |
| language | English |
| last_indexed | 2024-12-12T23:15:22Z |
| publishDate | 2014-11-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Oncology |
| spelling | doaj.art-a2c3d35e96c342bca8bb9ad2b888455c2022-12-22T00:08:28ZengKarger PublishersCase Reports in Oncology1662-65752014-11-017373974510.1159/000369005369005Delayed Intratumoral Hemorrhage after Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular CarcinomaKazue ShiozawaManabu WatanabeTakashi IkeharaYu OginoTomoko UmakoshiYasushi MatsukiyoMichio KogameTeppei MatsuiYoshinori KikuchiYoshinori IgarashiYasukiyo SuminoTransarterial chemoembolization (TACE) using a drug-eluting bead (DEB-TACE) for hepatocellular carcinoma (HCC) is a new treatment method. We report on a case of delayed intratumoral hemorrhage after DEB-TACE. An 81-year-old male with hepatitis C virus-related cirrhosis was diagnosed with a HCC of 35 mm in diameter in S5 detected by dynamic computed tomography (CT) and contrast-enhanced ultrasonography (CEUS). DEB-TACE with DC Bead® and epirubicin hydrochloride was performed because the patient declined to undergo surgical resection. The treatment was completed, and the course after DEB-TACE was favorable. However, right hypochondriac pain suddenly developed about 1 month after DEB-TACE. Unenhanced CT showed an increase of the tumor diameter and intratumoral high-intensity area, which was not enhanced in the arterial phase. CEUS performed at the time of right hypochondriac pain (5 weeks after DEB-TACE) showed nonenhancement of almost the entire tumor in the vascular phase. The cause of the symptom may have been DEB-TACE-associated intratumoral hemorrhage. Tumor hemorrhage has been reported after DEB-TACE with tumors >5 cm in diameter, and the tumor locations were subcapsular in all previous reports. There has been no case of a tumor with a diameter <5 cm distinct from the subcapsular, as was observed in our patient. Incomplete embolization might be the cause of the intratumoral hemorrhage experienced by this case presenting a few risks. To obtain the therapeutic effect of DEB-TACE while preventing the adverse events, it may be important to understand the characteristics of the beads and to apply the appropriate embolization to each individual case.http://www.karger.com/Article/FullText/369005Drug-eluting beadContrast-enhanced ultrasonographyTransarterial chemoembolizationHepatocellular carcinomaIntratumoral hemorrhage |
| spellingShingle | Kazue Shiozawa Manabu Watanabe Takashi Ikehara Yu Ogino Tomoko Umakoshi Yasushi Matsukiyo Michio Kogame Teppei Matsui Yoshinori Kikuchi Yoshinori Igarashi Yasukiyo Sumino Delayed Intratumoral Hemorrhage after Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma Case Reports in Oncology Drug-eluting bead Contrast-enhanced ultrasonography Transarterial chemoembolization Hepatocellular carcinoma Intratumoral hemorrhage |
| title | Delayed Intratumoral Hemorrhage after Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma |
| title_full | Delayed Intratumoral Hemorrhage after Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma |
| title_fullStr | Delayed Intratumoral Hemorrhage after Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma |
| title_full_unstemmed | Delayed Intratumoral Hemorrhage after Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma |
| title_short | Delayed Intratumoral Hemorrhage after Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma |
| title_sort | delayed intratumoral hemorrhage after drug eluting bead transarterial chemoembolization for hepatocellular carcinoma |
| topic | Drug-eluting bead Contrast-enhanced ultrasonography Transarterial chemoembolization Hepatocellular carcinoma Intratumoral hemorrhage |
| url | http://www.karger.com/Article/FullText/369005 |
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