Transarterial chemoembolization in atypical hepatocellular carcinoma

Abstract

Una de las grandes controversias dentro del manejo médico integral del carcinoma hepatocelular es la estimación precisa de la efectividad de la terapia con quimioembolización transarterial. Las evidencias demuestran que la misma hace parte del núcleo de tratamiento para aquellos pacientes con tumores no resecables y, comparado con la resección hepática y ablación por radiofrecuencia, oferta supervivencia a largo plazo si cumplen las características de nódulo hasta 3 cm o menores sin invasión vascular. Presentamos un caso clínico de carcinoma hepatocelular atípico con manejo médico integral, mediante la quimioembolización transarterial, evidenciando por imágenes y macroscópicamente la efectividad de la misma hasta el trasplante hepático ortotópico.

Bland Embolization and Transarterial Chemoembolization in Hepatocarcinoma

“…Regarding published Latin American experiences, there are documents dating back to the 2000s where the first experiences with TACE in countries such as Chile, 41 Ecuador, 42 Guatemala, 43 Colombia, 44 Mexico, 45 and Brazil 46 were publication of case series and based their conclusions fundamentally on the feasibility of the technique, the low incidence of complications, its good tolerance, and the The lesion marked out with yellow arrow in each picture corresponds to the lesion pointed out with an asterisk in the picture "a" in the liver segment VII. mRECIST was not possible to be calculated because it was considered noncomparable pre-and post-TACE imaging modality (first was CT angiography and post-TACE it was MRI); therefore LI RADS was reported, which was considered LR-TR viable due to focal lesions in segment VII considered with findings of embolization and persistence of viable tumor and multiple not measurable lesions suggestive of hepatocarcinoma (e: T1 out of phase, f: T1 in phase, g: T1 fat sat, h: T2 fat sat, i: diffusion, j: ADC, k: early arterial phase, l: arterial phase, m: portal phase).…”

“…Regarding published Latin American experiences, there are documents dating back to the 2000s where the first experiences with TACE in countries such as Chile, 41 Ecuador, 42 Guatemala, 43 Colombia, 44 Mexico, 45 and Brazil 46 were publication of case series and based their conclusions fundamentally on the feasibility of the technique, the low incidence of complications, its good tolerance, and the enthusiasm to continue improving and refining the technique and indications of this treatment itself. 46…”