A case of advanced hepatocellular carcinoma with right hepatic artery diverging from superior mesenteric artery, effectively treated with hepatic arterial infusion chemotherapy using special reservoir system indwelling in aorta named System-I

Abstract

We hereby report a case of advanced hepatocellular carcinoma (HCC) with right hepatic artery (RHA) diverging from superior mesenteric artery (SMA), which completely responded to hepatic arterial infusion chemotherapy (HAIC) using special reservoir system indwelling in aorta named System-I. A 71-year-old man suffering from HCV-related liver cirrhosis was referred to our hospital to treat multiple HCCs in April 2005. Although transarterial chemolipiodolization was performed twice, the tumors progressed. Then, we undertook a therapy with low-dose cisplatin and 5-fluorouracil (low-dose FP) using System-I. We changed the position of the microcatheter alternatively in RHA and LHA every week. After 8 cycles of the low-dose FP therapy, computed tomography and angiography showed complete response of the HCCs, and levels of tumor markers (AFP and PIVKA-II) were normalized. We think that System-I is a very useful system that enables us to perform HAIC without changing the flow of replaced hepatic artery. © 2008 The Japan Society of Hepatology.