Rapid Intrahepatic Progression of Hepatocellular Carcinoma after Transarterial Chemoembolization: A Case Report

The prevalence of hepatocellular carcinoma (HCC) is increasing worldwide. Multiple strategies are available for its management including surgical removal, chemotherapeutic drugs, and ablative and chemoembolization procedures. Transarterial chemoembolization (TACE) is currently being used for the unresectable intrahepatic tumor with no vascular invasion or metastasis to other organs. The common adverse effects associated with this technique involve self-limiting fever, vomiting, and abdominal pain. Liver failure is reported in a few cases. In this report, we present a case of 37-year-old HCC patient who experienced rapid progression of tumor following TACE. Our patient came to the Gastroenterology & Hepatology Department, Nishtar Hospital, Multan, with signs concerning acute liver failure within a few months following TACE. On triphasic computed tomography (CT) scan, there was evidence of multiple new infiltrating lesions in both lobes of the liver and portal vein thrombosis, which were not present before TACE procedure. Hence, we made a diagnosis of acute, chronic liver disease due to the rapid intrahepatic progression of HCC. This is a rare side effect of TACE procedure and highlights the significance of proper counseling of the patients undergoing this intervention.