Evaluation of hepatocellular carcinoma after TACE

Case contributed by Prashant Mudgal


Elderly male underwent transcatheter arterial chemoembolization of hepatocellular carcinoma 4 weeks earlier.

Patient Data

Age: 66 years
Gender: Male

K/C/O hepatocellular carcinoma for post transcatheter arterial chemoembolization evaluation.

There is a focal lesion measuring approximately 7.7 x 5.2 cm noted in the segment VIII of the right lobe, the lesion shows accumulation of high density material within, consistent with the theraputic chemoembolization. The accumulation pattern of iodised oil observed in the plain scan appears inhomogeneous and shows focal defects. In the arterial phase the lesion shows enhancing areas within which show washout on venous and delayed phases suggestive of residual viable tumor.

There are patchy focal non enhancing areas noted within the lesion suggestive of necrotic areas.

Case Discussion

The hepatocellular carcinoma nourishes on the hepatic artery, transcatheter arterial chemoembolization (TACE) using iodized oil and anticancer drug is an effective treatment for small hepatocellular carcinoma.

Post procedural Imaging is generally advised after 3-4 weeks, either triple phase CT, dynamic MRI or contrastenhanced USG. The accumulation pattern of the iodized oil and enhancement pattern of the mass is to be observed to evaluate the response to the treatment.

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