Sloughing of Intraductal Tumor Thrombus of Hepatocellular Carcinoma After Transcatheter Arterial Chemoembolization

Abstract

Transcatheter arterial chemoembolization (TACE) is effective for hepatocellular carcinoma (HCC) with intrabile duct thrombus. After TACE, intraductal tumor thrombi occasionally detach from the intrahepatic tumor and drop into the bottom of the common bile duct, causing clinical symptoms similar to the impaction of choledocholithiasis. The investigators describe three cases of sloughing of HCC intraductal tumor thrombi after selective TACE. In each of the three cases, the necrotic tumor cast was successfully removed endoscopically, and the patient's symptoms were dramatically improved. Two patients survived without recurrence of the intraductal tumor thrombus for 8 and 11 months after TACE, respectively.

Excretion of necrotic hepatocellular carcinoma tissues into the biliary system after transcatheter arterial chemoembolization

“…It is well known that intraductal tumor thrombus is easily detached and excreted into the bile duct after TACE; however, in our experience, necrotic tumor tissues of large HCC without an intraductal tumor thrombus were also excreted into the biliary system after TACE. Thus, the purpose of this study was to retrospectively evaluate the incidence and condition of necrotic tumor excretion into the biliary system in patients with HCC >5 cm.…”

Acute Obstructive Cholangitis Complicated by Tumor Migration after Transarterial Chemoembolization: A Case Report and Literature Review

“…Our review of the literature identified eight apparent cases (including ours) of obstructive jaundice caused by tumor fragments from HCC after TACE (Table 1). [5][6][7][8][9] The patients (including ours) ranged in age from 62 to 82 years (mean age, 70.5 years) and consisted of five men and three women. Most patients showed bile duct invasion (six of the eight patients) and bile duct dilatation (six of the eight patients) on initial CT finding.…”

“…However, diagnosis is usually difficult, due to the low incidence rate, ignorance of this disease, and the difficulty of imaging diagnosis to find the BDT. [5][6][7][8][9] The aims of this study were to identify factors that affect tumor migration after TACE. Here, we describe a patient with acute obstructive cholangitis complicated by migration of a necrotic tumor cast after TACE for intrabile duct invasion of HCC and provide a review of the literature.…”

Sloughing of biliary tumour ingrowth of hepatocellular carcinoma after chemoembolization

“…Migration of intraductal tumour ingrowth to the distal common bile duct, causing obstructive jaundice, rarely occurs following chemoembolization of HCCs with bile duct invasion, which is the so-called 'sloughing' of an intraductal tumour ingrowth [9][10][11][12][13][14][15][16][17][18]. The clinical course of this event remains poorly documented.…”