Unusual atrophic change after repeated arterial therapy for hepatocellular carcinoma: report of a case

We report the case of a 45-year-old man with advanced hepatocellular carcinoma (HCC) who was able to undergo radical surgery after repeated transarterial therapy. Transarterial chemoembolization was repeated three times, and thereafter, transarterial infusion chemotherapy using Lipiodol was performed on the right hepatic artery. Because notable atrophy of the right lobe and compensated hypertrophy of the left lobe were detected after this therapy, an extended right lobectomy could be performed. Histologically, the HCC showed complete necrosis. The remarkable atrophic change of the right lobe was thought to be due to an obstruction of the right portal veins by the spread of inflammation around the bile duct necrosis, in addition to the narrowing of the hepatic artery. A thorough understanding of this phenomenon and the development of methods to clinically apply it in the treatment of cancer patients may thus lead to an increase in the percentage of resectable cases of advanced HCC.