A case report of hepatocellular carcinoma adjacent to hepatic biloma successfully treated by stereotactic body radiation therapy

Abstract

A 80-year-old man had been regularly followed up for hepatitis C since 2002. After hepatocellular carcinoma(HCC) initially developed in 2007, he underwent radiofrequency ablation (RFA) and transcatheter arterialchemoembolization (TACE) for several times. In 2013, 15-mm HCCs recurred both in segments 3 and 5. We firstconducted TACE and percutaneous ethanol injection therapy was added for HCC in segment 3. However, sinceHCC in segment 5 was adjacent to biloma developed by the past RFA, we performed stereotactic body radiationtherapy (SBRT) with a total dose of 40 Gy in 4 fractions. Consequently, complete response was achieved onemonth after SBRT without any adverse events. This lesion has been recurrence-free for 22 months.This is the first case report of HCC adjacent to biloma successfully treated by SBRT. Whereas ablationtherapies have a risk of bile duct injury, SBRT might be a safe and effective treatment option.