One of the shortcomings of percutaneous ethanol injection therapy (PEIT) is that many sessions are necessary to accomplish the treatment. In order to reduce the number of treatment sessions, we inserted two or three needles before injection of ethanol was begun. Using the multiple-needle insertion method, we markedly reduced the number of treatment sessions. Histopathologic examination, imaging techniques, and serum alpha-fetoprotein levels showed efficacy of PEIT using the multiple-needle insertion method. No serious complication occurred. Levels of transient pain, fever, and the feeling of intoxication did not seem to be different from those occurring with the conventional method. Multiple-needle insertion method may be valuable as a method for reducing the number of treatment sessions necessary and thus shortening the treatment period.
A 75-year-old woman was admitted to our hospital complaining of right hypochondrial pain. Echo sonography and computed tomography demonstrated a large tumor with irregular internal density in the right lobe of the liver. Angiography revealed a moderately hypervascular tumor. She was treated with transcatheter arterial embolization. Three weeks later, the tumor ruptured. She died of accompanying acute myocardial infarction seven months after the onset of the illness. Autopsy revealed primary fibrosarcoma of the liver. The tumor appearance varied from firm whitish to soft myxomatous. A part of the tumor showed hemorrhagic necrosis. There was no intrahepatic metastasis. The tumor tissue was composed of spindle shaped cells and immunohistochemically stained with vimentin.
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