Transcatheter Arterial Embolization Through Extrahepatic Collaterals in Ruptured Hepatocellular Carcinoma–A Case of Second–Stage Surgery

Abstract

We present a case of hepatocellular carcinoma (HCC) rupture involving transhepatic arterial embolization (TAE) containing extrahepatic collaterals followed by elective surgery. A 62–year–old man admitted for right hypochondralgia. Computed tomography (CT) showed an 8 cm tumor at the right hepatic lobe with a huge subcapsular hemorrhage. Angiography showed the tumor to be hypervascular and by the right hepatic artery (RHA) and extrahepatic collaterals. Under a diagnosis of ruptured HCC, TAE was done through the RHA, collaterals;omental artery, and right intercostal arteries. His vital signs became stable. He underwent second–stage right hepatectomy 31 days after TAE and was discharged on postoperative day 80. He remains well without evidence of recurrence in the over 18 months since elective surgery.