A case of hepatocellular carcinoma in the caudate lobe successfully treated by transcatheter arterial chemoembolization using drug-eluting beads

Abstract

Hepatocellular carcinoma (HCC) in the caudate lobe remains one of the most intricate locations where various treatments tend to pose problems with regard to the optimal approach. Surgical resection has been regarded as the most effective treatment; however, isolated resection of the caudate lobe is strenuous and associated with a high rate of early recurrence. Percutaneous ablation might be technically difficult or impossible to perform due to the deep location of tumors and adjacent large vessels. Treatment with drug-eluting beads (DEB) can potentially enhance the therapeutic efficacy for patients with unresectable HCC by drawing on the slower, more consistent drug delivery process. We described a case of a 62-year-old man with HCC in the caudate lobe who was successfully treated by DEB.

Fogarty-assisted flow redirection during conventional transarterial chemoembolization for caudate lobe hepatocellular carcinoma

“…TACE has been utilized for the treatment of caudate lobe HCC but can be technically difficult for interventional radiologists. [5] e reported technical success rate for selective caudate lobe TACE is 71% with local recurrence at 77%. [6] e difficulties with both interventional and surgical treatments for caudate disease lead to its poor prognosis.…”

“…[6] e difficulties with both interventional and surgical treatments for caudate disease lead to its poor prognosis. [5] While proximal occluding catheters are commonly used to perform embolization in TACE and TARE, the utilization of distal occlusion for proximal delivery is rare [7] However, in caudate HCC disease, arterial supply has a propensity for complex origins. For example, Yoon et al reported two direct proper hepatic arteries supply in 175 caudate lobe HCC cases.…”