A therapeutic effective case of bronchial arterial infusion of fine-powder cisplatin (IA-call^®) for pulmonary metastases originated from hepatocellular carcinoma

Abstract

A 73 year-old man who was diagnosed as hepatocellular carcinoma (HCC) underwent extended right hepatic lobectomy. Four years after the hepatectomy, multiple nodules in bilateral lungs were detected. A diagnostic percutaneous biopsy revealed pulmonary metastases from HCC. The patient was treated with oral uracil/tegafur (UFT) first. However, his condition deteriorated because of refractory massive hemoptysis. Therefore, bronchial arterial infusion (BAI) of epirubicin (EPI) was performed twice for a metastatic mass at right pulmonary hilum. In contrast to decreasing trend of tumor burden, improvement of hemoptysis was not observed. The replacement of EPI with fine-powder cisplatin (IAC) finally contributed to complete disappearance of a metastatic mass and his symptom. Additional treatment for another nodule at right azygos lobe was successfully performed as well. The efficacy of BAI for the other metastatic nodules without hypervascular stain by angiography was not certified. BAI could be a useful therapeutic option for symptomatic pulmonary metastases, if the primary lesion is well-controlled.