-Case Reports-

Successful Transcatheter Chemoembolization for Acute Jaundice in a Patient with Advanced Hepatocellular Carcinoma and Portal Vein Tumor Thrombosis: A Case Report

Keisuke Inui, Yasuhiro Takahashi, Hirokazu Komeichi, Yasumi Katsuta, Shuji Shimizu and Kyouichi Mizuno

Division of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School

A 54-year-old man with suspected cirrhosis and a hepatic tumor on positron emission tomography presented to our hospital for assessment and treatment in January 2007. Laboratory tests and diagnostic imaging revealed that the patient had cirrhosis due to hepatitis B virus infection and advanced hepatocellular carcinoma (HCC) along with portal vein tumor thrombosis (PVTT) (T4N1M0, Child's B). After hospitalization, the serum levels of total and direct bilirubin increased markedly within several days (26.0 and 20.0 mg/dL), and biliary obstruction by the tumor appeared to have caused this sudden jaundice. To treat the biliary obstruction, selective transcatheter chemoembolization (TACE) was performed via the feeding arteries of the tumor in the anterior segment of the right lobe. After TACE, total bilirubin decreased to 7.0 mg/dL, and the patient survived for 4 more months.

J Nippon Med Sch 2009; 76: 217-220

Keywords
hyperbilirubinemia, hepatocellular carcinoma, portal vein tumor thrombosis, transcatheter arterial chemoembolization

Correspondence to
Keisuke Inui, Division of Cardiology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
inupi@nms.ac.jp

Received, January 16, 2009
Accepted, June 9, 2009