Primary Hepatocellular Carcinoma

Transarterial Embolization for Advanced HCC in a 69-year Old Male with prior therapies

Clinical Background

A 69-year-old male with advanced HCC and prior systemic and locoregional treatments presented with a residual tumor in Segment V of the liver. The primary lesion measured 4.7 cm, was focal and encapsulated, with evidence of extrahepatic disease. Imaging demonstrated a 1.5 cm area of residual enhancement, and embolization was pursued as a disease control strategy.

Baseline CT

Pre-HES Embolization Angiogram

Tumor Characteristics

  • Location: Segment V, liver
  • Size: 4.7 cm (residual 1.5 cm enhancement)
  • Morphology: Focal, encapsulated
  • Extrahepatic Disease: Present

Post-HES Embolization Angiogram

Intervention Details

  • Approach: Transarterial Embolization with Embrace HES via transradial access
  • Vessel Treated: 1 measuring 3 mm
  • Volume Delivered: 1.6 mL
  • Procedure Outcome: Technical success reported by both site and core lab

30 Day Follow-Up CT

30-Day Outcome

  • Core Lab Reported a Complete response per mRECIST
  • No local tumor progression

90 Day Follow-Up CT

90-Day Outcome

  • Core Lab reported a Complete response per mRECIST
  • No local tumor progression
  • No revascularization

Conclusion

At 90-day follow-up, the independent core lab confirmed a complete response (mRECIST), with no evidence of tumor progression or revascularization. This case underscores the effectiveness of embolization in an advanced-stage HCC patient with limited therapeutic options, demonstrating sustained local disease control despite prior systemic therapy, bland embolization, and extrahepatic disease.

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