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A synchronous hepatocellular carcinoma and renal cell carcinoma treated with radio-frequency ablation.

Lee YS, Kim JH, Yoon HY, Choe WH, Kwon SY, Lee CH - Clin Mol Hepatol (2014)

Bottom Line: Transarterial chemoembolization (TACE) was performed to treat the HCC.Therefore, we performed RFAs to treat HCC and RCC.There was no evidence of recurrence in the follow up image after 1 month.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.

ABSTRACT
Radio-frequency ablation (RFA) is a curative treatment for hepatocellular carcinoma (HCC). Percutaneous RFA has been shown to be beneficial for patients with small renal cell carcinoma (RCC) lacking indications for resection. We experienced the case of a 53-year-old male who had conditions that suggested HCC, RCC, and alcoholic liver cirrhosis. Abdominal contrast-enhanced computed tomography (CT) and magnetic resonance image showed liver cirrhosis with 2.8 cm ill-defined mass in segment 2 of the liver and 1.9 cm hypervascular mass in the left kidney. These findings were compatible with the double primary cancers of HCC and RCC. Transarterial chemoembolization (TACE) was performed to treat the HCC. After the TACE, a focal lipiodol uptake defect was noticed on a follow up CT images and loco-regional treatment was recommended. Therefore, we performed RFAs to treat HCC and RCC. There was no evidence of recurrence in the follow up image after 1 month.

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(A) About 2.8 cm hyperintense mass in the S2 of the liver was examined in T2 weighted MRI. (B) About 1.9 cm hypointense mass in the mid pole of the left kidney was examined in T1 weighted MRI.
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Figure 3: (A) About 2.8 cm hyperintense mass in the S2 of the liver was examined in T2 weighted MRI. (B) About 1.9 cm hypointense mass in the mid pole of the left kidney was examined in T1 weighted MRI.

Mentions: A-53-year-old man visited our hospital with general weakness. He was referred to our hospital because of condition that suggested HCC, RCC, and alcoholic liver cirrhosis. His past medical history only included diabetes mellitus (DM). He has no family history of disease. The patient has a 30 pack-year smoking history and would drink so ju (a Korean distilled spirits), approximately 2-3 bottles daily for the previous 3 months. The serum bilirubin was 2.6 mg/dL, serum albumin was 2.9 g/dL, and prothrombin time (INR; International Normalized Ratio) was 1.26. A small amount of ascites was observed. Hepatic encephalopathy was not observed (Child-Pugh score 9, stage B). Abdominal contrast-enhanced computed tomography (CT) and magnetic resonance image (MRI) showed liver cirrhosis with 2.8 cm ill-defined mass in segment 2 of the liver and 1.9 cm hypervascular mass in left kidney. An enhancing mass, approximately 2.8 cm, without an apparent border in the arterial phase and washed out in delayed phase was noticed in S2 of the liver (Fig. 1). A mass with a thickened smooth wall, approximately 1.9 cm, in the enhancing arterial phase in left kidney was noticed in the arterial phase in a CT image (Fig. 2). These findings were compatible with double primary cancers of HCC and RCC. There was no evidence of lymph node or distant metastasis. In S2 of the liver, a hypervascular mass, approximately 2.8 cm was noticed in the T2 weighted image in the MRI and an approximate 1.9 cm mass in the left kidney was noticed in a T1 weighted image in the MRI (Fig. 3). The serum alpha fetoprotein (AFP) was 6.93 ng/mL and the serum protein induced by vitamin K absence/antagonist-II (PIVIKA-II) was 23 mAU/mL. The HBsAg, Anti-HBs and Anti-HCV were all negative. Transarterial chemoembolization (TACE) was performed to treat the HCC. Two days after the TACE, the focal lipiodol uptake defect was noticed in follow up CT images and loco-regional treatment was recommended. No other significant abnormal hypermetabolic lesion suggesting malignancy was noticed on positron emission tomography-CT (PET-CT). Therefore, we performed RFAs to treat HCC and RCC. There was no significant complication after the procedure. One month later, follow-up CT images were taken. There was no evidence of recurrence (Fig. 4).


A synchronous hepatocellular carcinoma and renal cell carcinoma treated with radio-frequency ablation.

Lee YS, Kim JH, Yoon HY, Choe WH, Kwon SY, Lee CH - Clin Mol Hepatol (2014)

(A) About 2.8 cm hyperintense mass in the S2 of the liver was examined in T2 weighted MRI. (B) About 1.9 cm hypointense mass in the mid pole of the left kidney was examined in T1 weighted MRI.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4197180&req=5

Figure 3: (A) About 2.8 cm hyperintense mass in the S2 of the liver was examined in T2 weighted MRI. (B) About 1.9 cm hypointense mass in the mid pole of the left kidney was examined in T1 weighted MRI.
Mentions: A-53-year-old man visited our hospital with general weakness. He was referred to our hospital because of condition that suggested HCC, RCC, and alcoholic liver cirrhosis. His past medical history only included diabetes mellitus (DM). He has no family history of disease. The patient has a 30 pack-year smoking history and would drink so ju (a Korean distilled spirits), approximately 2-3 bottles daily for the previous 3 months. The serum bilirubin was 2.6 mg/dL, serum albumin was 2.9 g/dL, and prothrombin time (INR; International Normalized Ratio) was 1.26. A small amount of ascites was observed. Hepatic encephalopathy was not observed (Child-Pugh score 9, stage B). Abdominal contrast-enhanced computed tomography (CT) and magnetic resonance image (MRI) showed liver cirrhosis with 2.8 cm ill-defined mass in segment 2 of the liver and 1.9 cm hypervascular mass in left kidney. An enhancing mass, approximately 2.8 cm, without an apparent border in the arterial phase and washed out in delayed phase was noticed in S2 of the liver (Fig. 1). A mass with a thickened smooth wall, approximately 1.9 cm, in the enhancing arterial phase in left kidney was noticed in the arterial phase in a CT image (Fig. 2). These findings were compatible with double primary cancers of HCC and RCC. There was no evidence of lymph node or distant metastasis. In S2 of the liver, a hypervascular mass, approximately 2.8 cm was noticed in the T2 weighted image in the MRI and an approximate 1.9 cm mass in the left kidney was noticed in a T1 weighted image in the MRI (Fig. 3). The serum alpha fetoprotein (AFP) was 6.93 ng/mL and the serum protein induced by vitamin K absence/antagonist-II (PIVIKA-II) was 23 mAU/mL. The HBsAg, Anti-HBs and Anti-HCV were all negative. Transarterial chemoembolization (TACE) was performed to treat the HCC. Two days after the TACE, the focal lipiodol uptake defect was noticed in follow up CT images and loco-regional treatment was recommended. No other significant abnormal hypermetabolic lesion suggesting malignancy was noticed on positron emission tomography-CT (PET-CT). Therefore, we performed RFAs to treat HCC and RCC. There was no significant complication after the procedure. One month later, follow-up CT images were taken. There was no evidence of recurrence (Fig. 4).

Bottom Line: Transarterial chemoembolization (TACE) was performed to treat the HCC.Therefore, we performed RFAs to treat HCC and RCC.There was no evidence of recurrence in the follow up image after 1 month.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.

ABSTRACT
Radio-frequency ablation (RFA) is a curative treatment for hepatocellular carcinoma (HCC). Percutaneous RFA has been shown to be beneficial for patients with small renal cell carcinoma (RCC) lacking indications for resection. We experienced the case of a 53-year-old male who had conditions that suggested HCC, RCC, and alcoholic liver cirrhosis. Abdominal contrast-enhanced computed tomography (CT) and magnetic resonance image showed liver cirrhosis with 2.8 cm ill-defined mass in segment 2 of the liver and 1.9 cm hypervascular mass in the left kidney. These findings were compatible with the double primary cancers of HCC and RCC. Transarterial chemoembolization (TACE) was performed to treat the HCC. After the TACE, a focal lipiodol uptake defect was noticed on a follow up CT images and loco-regional treatment was recommended. Therefore, we performed RFAs to treat HCC and RCC. There was no evidence of recurrence in the follow up image after 1 month.

Show MeSH
Related in: MedlinePlus