Post-embolization Syndrome Following Yttrium-90 Radiation Segmentectomy.

Area of Science:

• Hepatobiliary oncology
• Interventional radiology
• Oncologic imaging

Background:

• Post-embolization syndrome (PES) is a known complication following transarterial embolization (T AE) for hepatocellular carcinoma (HCC).
• PES typically manifests 24-72 hours post-procedure with symptoms like fever, nausea, abdominal pain, and elevated liver enzymes.
• While documented after transarterial chemoembolization (TACE), delayed onset PES is less common.

Observation:

• A 70-year-old male with HCC presented with delayed symptoms suggestive of PES.
• The patient had previously undergone a transarterial radioembolization (T ARE) procedure.
• The onset of symptoms occurred significantly later than the typical 24-72 hour window.

Findings:

• This case represents an unusual presentation of delayed-onset post-embolization syndrome.
• The patient's symptoms developed after transarterial radioembolization, a variant of T AE.
• The delayed manifestation challenges the conventional understanding of PES timing.

Implications:

• This case expands the clinical spectrum of post-embolization syndrome.
• It suggests that delayed PES should be considered in patients with HCC undergoing T ARE.
• Further investigation into the pathophysiology and timing of PES after T ARE is warranted.