The patient was an 80-year-old male with right hepatic giant hepatocellular carcinoma discovered in September 2011 due to distension in the liver area, with a history of hepatitis B and grade A liver function.
In September 2011, the patient was found to have a giant hepatocellular carcinoma of the right liver with marked enhancement in the arterial phase and relatively clear borders. The upper edge of the lesion reached the top of the diaphragm.
The lesion was significantly intensified
The lesion was significantly intensified
The lesion is compressing the right branch of portal vein with partial necrosis inside
The lesion is clearly intensified
Significantly intensified lesion
Significantly intensified lesion
Significant enhancement of the lesion
Because the patient was 80 years old and the tumor was huge, considering the risk of surgery, surgery was abandoned and TACE was performed.
After 3 times of TACE, the iodine oil deposition of the lesion was still acceptable and the tumor was basically stable.
In December 2011, CT-guided radiofrequency ablation treatment was performed.
The tumor was punctured at multiple points with cool-tip cluster RF electrodes and treated with high-power prolonged ablation.
Radiofrequency ablation treatment.
Radiofrequency ablation treatment was taken for pathological examination at the same time.
In January 2012, most of the tumor was necrotic, but there were still surviving tumors in the periphery and poor iodine oil deposition.
Most of the tumor was necrotic.
Interventional embolization treatment was continued.
Interventional embolization was continued in March 2012.
After interventional treatment, the iodine oil deposition of the lesion was still unsatisfactory, and cryoablation with Ar-He knife was performed in May 2012.
Cryoablation with argon helium knife was performed.
Interventional treatment again in June 2012
On review in August 2012, there were still more residual tumors and poor iodine oil deposition.
October 2012 Double-needle microwave ablation treatment.
October 2012 Double-needle microwave ablation treatment.
Microwave ablation treatment.
January 2013 The patient developed subfoci in the left liver and was treated with argon helium knife cryoablation.
January 2013 The right liver tumor was treated again with argon helium knife cryoablation.
March 2013 Double needle microwave ablation treatment again.
August 2013 Re-intervention.
Aug 2013 Interventional treatment with iodine oil deposition was fair.
Feb 2014 Multiple metastases in both lungs.
Feb 2014 Significant progression of liver tumor.
Supportive therapy was recommended. Subsequently treated with oral sorafenib after discussion with the patient.
Onset in September 2011 and the patient died in early 2015 due to systemic failure, surviving for more than three years.
Point of view.
The patient was already 80 years old at the time of onset, and surgery was not adopted because of the high risk.
The lesion was rich in arterial blood supply, and after three TACE procedures, the first radiofrequency ablation treatment was started.
One and a half years after the onset of the disease, a subfoci started to appear in the left liver of the patient.
Despite several subsequent interventions and ablative treatments, one year after the appearance of subfoci, the patient already had multiple metastases in both lungs and uncontrollable growth of liver tumors. Supportive therapy was recommended and the patient later chose to take oral sorafenib and eventually survived for more than three years before dying of systemic failure, at which time the patient was 83 years old.
This case is not very successful, but the survival of the giant liver cancer for more than three years is a relatively good result, which may be related to the slow metabolism of the patient in old age and the slow progression of the tumor.