US-guided percutaneous alcohol injection of small hepatic and abdominal tumors

Fourteen lesions (nine hepatocellular carcinomas, four hepatic metastases from gastric carcinoma, and one peritoneal metastasis from transitional cell carcinoma) in 12 patients were treated with percutaneous injection of 95% ethyl alcohol under guidance with ultrasound. Requirements for this procedure included inadequate response to conventional treatment or refusal of surgery, easy identification of the tumor with sonography, and a tumor diameter less than 4 cm. Three to nine administrations (75 in all) were performed for each lesion according to its size and to the results of the fine needle biopsy. All lesions had posttreatment sonographic structural changes of fibronecrotic degeneration. All lesions less than 3.2 cm in diameter (11 cases) that underwent the final fine needle biopsy were negative for malignant cells and had volume reductions up to 100%. No biochemical changes or untoward clinical sequelae were detected. Percutaneous intratumoral alcohol injection is inexpensive, easy to perform, and potentially valuable in the treatment of selected small neoplastic lesions of the liver and abdomen.