Tumor calcification and sustained complete response after chemoembolization in hepatocellular carcinoma: Two case reports and review of literature
1Interventional Radiology Unit/Department of Radiology and Medical Imaging, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia. drsultan000@gmail.com.
Background:
Transarterial chemoembolization (TACE) is a widely accepted palliative therapy modality for unresectable hepatocellular carcinoma (HCC). Although it is rarely curative, complete radiological response can be achieved in selected patients, leading to prolonged survival. Post-treatment tumoral calcification is an uncommon imaging finding in HCC and is rarely reported after drug-eluting beads TACE (DEB-TACE).
Case Summary:
Two patients with large, solitary HCCs (> 5 cm) were treated with DEB-TACE, and both achieved complete radiological response after two treatment sessions. Approximately 1 year after DEB-TACE, imaging demonstrated progressive peripheral tumoral calcification. Over 6 years of follow-up, both patients remained in remission with preserved liver function.
Conclusion:
These two cases highlight the potential for complete remission and long-term survival in selected patients with large HCC following DEB-TACE. The appearance of peripheral calcification may represent a late imaging marker of effective tumor necrosis and durable treatment response although prospective studies are warranted to clarify its prognostic value.
