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Image of the Month—Diagnosis
Arch Surg. 2009;144(3):286.
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Answer: Gastrohepatic Fistula Following TACE for HCC
Transarterial chemoembolization is a commonly used treatment modality for unresectable HCC. It involves the use of transarterial catheters to deliver local high doses of chemotherapy to the tumor. Often, particulate embolic agents are also administered with the chemotherapy to eliminate the arterial vascular supply of the lesion. Transarterial chemoembolization therapy can be quite effective in treating HCC, resulting in tumor response in 16% to 61% of patients.1 Data on whether TACE offers a survival benefit to patients with HCC remains somewhat controversial.2 Two randomized trials3-4 have suggested that there is no survival benefit, while 2 other randomized studies have reported an improvement in survival following TACE.5-6 Although TACE can usually be performed safely, it can be associated with complications. The most common complication is acute liver failure secondary to hepatic necrosis. Other complications include acute renal failure, encephalopathy, and gastrointestinal bleeding. More rare ischemic complications have also been reported, including . . . [Full Text of this Article]
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Image of the Month—Quiz Case
Ajay Jain, Christopher Smith, Jean-Francois H. Geschwind, and Timothy M. Pawlik
Arch Surg. 2009;144(3):285.
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