Hepatocellular carcinoma with extrahepatic blood supply from right renal artery

Abstract

Extrahepatic blood supply is seen in around 17–27% of hepatocellular carcinoma lesions. Evidence suggests that this extrahepatic supply most commonly originates from a right intercostal artery (70–83%) followed by left intercostal, omental and right renal arteries. Thus a comprehensive knowledge of variations in standard vascular anatomy and cognisance of factors influencing or predicting extrahepatic blood supply in HCC is instrumental in ensuring the success of surgical and interventional procedures. We present the unusual case of a 66-year-old male with HCC in Segment I of the liver with aberrant blood supply from the right renal artery in the absence of any risk factors for extrahepatic circulation. He successfully underwent transarterial chemoembolization. There was no evidence of residual disease on repeat imaging.

Precision Imaging Guidance in the Era of Precision Oncology: An Update of Imaging Tools for Interventional Procedures

“…It also should be taken into consideration that HCC could have an extrahepatic arterial supply, which has been reported in about 17–27% of cases [ 106 ]. The identification of extrahepatic feeding vessels is mandatory to ensure a complete treatment and to avoid hemorrhagic complications [ 98 , 107 ].…”

“…Since then, automated or semi-automated software for the tumor-feeding arteries was developed and is widely used [102][103][104], with an excellent detection rate of the arterial feeding vessels [105] (Figure 7). It also should be taken into consideration that HCC could have an extrahepatic arterial supply, which has been reported in about 17-27% of cases [106]. The identification of extrahepatic feeding vessels is mandatory to ensure a complete treatment and to avoid hemorrhagic complications [98,107].…”

“…The added value of CBCT for transarterial liver treatment is clear in terms of tumor and feeding vessel detection; however, it is not completely clear if this may result in improving tumor response, and several efforts are made in this direction [108]. An interesting new development is virtual liver perfusion mapping, which is a technique that allows It also should be taken into consideration that HCC could have an extrahepatic arterial supply, which has been reported in about 17-27% of cases [106]. The identification of extrahepatic feeding vessels is mandatory to ensure a complete treatment and to avoid hemorrhagic complications [98,107].…”