The Effect of Transcatheter Arterial Chemo-Embolization Combined Lipiodol, to Tumor Embolus in the Hepatic Vein of Hepatocellular Carcinoma

Yasuo Miyoshi, Yo Sasaki, Shingi Imaoka, Takashi Shibata, Tadashi Yasuda, Hisashi Wada, Hiroaki Nagano, Osamu Ishikawa, Hiroshi Furukawa, Takeshi Iwanaga

Department of Surgery, The Center for Adult Diseases, Osaka

To two cases of hepatocellular carcinoma with tumor emboli in the hepatic vein, we performed hepatectomy after Lipiodol transcatheter arterial chemo-embolization (LPD-TAE). We estimated the histological effect of LPD-TAE on these tumor emboli in the hepatic vein. The conclusion was as follows: in case 1, the tumor embolus in the right hepatic vein was completely necrosed. Daughter nodules were diagnosed histologically as solid type Edmondson grade II hepatocellular carcinoma. The angiographic appearance showed no "thread and streaks" sign in this embolus. In case 2, the effect was only partial necrosis of the tumor embolus in the right hepatic vein. Histologically, sinusoidal type Edmondson grade III hepatocellular carcinoma was found in the tumor embolus and daughter nodules. Angiographically, the "thread and streaks" sign was clearly recognized in this embolus. Then, like these cases, the existence of the angiographic "thread and streaks" sign might lead to poor effect of LPD-TAE to tumor embolus in the hepatic vein of hepatocellular carcinoma.

Key words
hepatocellular carcinoma, tumor embolus in the hepatic vein, transcatheter arterial embolization

Reprint requests
Yasuo Miyoshi Department of Surgery, The Center for Adult Diseases, Osaka
1-3-3 Nakamichi, Higashinari-ku, Osaka, 553 JAPAN

Accepted
December 13, 1989

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