Chemoembolization for hepatocellular carcinoma.
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Fifty-one patients with unresectable hepatocellular carcinoma (HCC) were treated with Gelfoam (absorbable gelatin sterile powder; The Upjohn Co, Kalamazoo, MI) chemoembolization. A mixture of Gelfoam powder, contrast media, and three drugs (doxorubicin, mitomycin, and cisplatin) was injected under fluoroscopic guidance via a percutaneous catheter into the hepatic artery until stagnation of blood flow was achieved. Of the 51 patients, 50 are assessable for response, and all are assessable for toxicity and complications. The median percent of liver replacement was 50% (range, 15% to 95%). By conventional response criteria, there were 12 partial responses (PRs) (24%), 13 minor responses (MRs) (26%), 12 stabilization of disease (SD) (24%), and 13 (26%) progressive disease (PD). Tumor liquefaction was noted on computed tomographic (CT) scan in 35 of 50 patients (70%). Of the 34 patients with elevated alpha-fetoprotein (AFP), 23 (68%) had a greater than 50% reduction following treatment. Responding patients were re-treated at the time of tumor progression if they still met the entry criteria. The median survival of assessable patients from the time of treatment was 207 days and from the diagnosis of the primary was 302 days. Fourteen patients remain alive at 3 months to 3 years following treatment. The vast majority of patients had transient pain, fever, nausea, and elevation in liver enzymes. Ascites developed in 14 patients. There were two treatment-related deaths: one from tumor hemorrhage and one from liver failure. Chemoembolization appears to have significant activity in patients with hepatocellular carcinoma and is relatively well tolerated. (+info)
Acute and subacute dual energy CT findings of pulmonary embolism in rabbits: correlation with histopathology.
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Transarterial embolization with use of lipiodol and gelatin sponge for active nasal bleeding from hepatocellular carcinoma metastasis in the pituitary gland.
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A 58-year-old man presented with a very rare case of pituitary metastasis from hepatocellular carcinoma with active nasal bleeding which was treated by transarterial embolization using ethiodized oil (Lipiodol) and gelatin sponge. After treatment, nasal bleeding ceased and tumor size decreased. The prognosis for patients with pituitary metastases is very poor, so aggressive treatment is recommended to alleviate symptoms. This minimally invasive approach may be a reasonable therapeutic option for pituitary metastases. (+info)
Small bowel obstruction after FloSeal use.
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