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Successful TACE for HCC

Successful TACE for HCC. History. A 50 y/o white male with a history of HCV cirrhosis, who was referred for an evaluation for liver transplantation Risk factors for HCV included: 1) Ex-IVDU in the 1960’s 2) Multiple blood transfusions in 1975. History.

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Successful TACE for HCC

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  1. Successful TACE for HCC

  2. History • A 50 y/o white male with a history of HCV cirrhosis, who was referred for an evaluation for liver transplantation • Risk factors for HCV included:1) Ex-IVDU in the 1960’s2) Multiple blood transfusions in 1975

  3. History • His end-stage liver disease was complicated by: 1) Esophageal variceal bleed 2) Portosystemic encephalopathy 3) Ascites 4) Hepatic lesion measuring 6 x 6.5 x 7cm in segment 7 with an elevated serum AFP > 16,000 ng/ml

  4. Physical Examination • HEENT: Sclera anicteric • ABD: Hepatomegaly of 16 cm, splenomegaly No shifting dullness • EXT: 1+ pitting edema of lower extremities. No asterixis • Neuro: AO x3

  5. Laboratory Data WBC 3.6/ul Albumin 2.5 g/dlHb 9.5 g/dl AST 148 U/LPlatelets 50/ul ALT 118 U/LCreatinine 1.0 g/dl INR 1.22MELD 13 Total bili 3.4 mg/dlAFP 13,874 ng/ml

  6. Figure – 1 (CT scan of 1/29/02)

  7. Subsequently in February 2002, He underwent chemoembolization with mitomycin, adriamycin and carboplatinum

  8. Figure –2 (CT scan of 4/10/02)

  9. Serial serum AFP levels decreased to: - 164 ng/ml in 5/02 - 113 ng/ml in 7/02

  10. On August 25, 2002 the patient underwent cadaveric liver transplantation

  11. Figure – 3 (Explant 8/25/02).

  12. After 7 months of follow-up • The patient is doing well • There is no evidence of recurrence on serial abdominal imaging and serum AFP levels • Since there was no evidence of hepatocellular carcinoma on explant, the decision was made not to treat patient with chemotherapy

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