A case of advanced hepatocellular carcinoma successfully treated by combined therapies including transarterial chemoembolization using Lipiodol- CDDP powder suspension

We report a case of advanced multiple hepatocellular carcinomas (HCC), successfully treated by combination therapies of transarterial chemoembolization (TACE), surgical operation and radiofrequency ablation therapy (RFA). The patient was a 60-year-old man, who had been investigated in another hospital for abdominal pain and general fatigue, and was subsequently referred to our hospital with a diagnosis of HCC. A huge tumor with a diameter larger than 10 cm and a set of multiple intrahepatic metastases (IM) to bilateral lobes were recognized. In addition, portal vein tumor thrombosis of the left branch (Vp3) was observed. He received serial treatments with TACE using lipiodol- CDDP powder suspension. After 4 courses of this therapy. CT revealed that these IM tumors had disappeared. Therefore we performed a left hepatic lobectomy. Then he was treated with RFA. He has still been well for 28 months since the first detection of HCC. It was suggested that a TACE using CDDP powder may be one of the most effective treatment modalities against advanced HCC.