World journal of clinical oncology · 2025
Yttrium-90 radioembolization for advanced hepatocellular carcinoma with Budd-Chiari syndrome: A case report.
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Shao Ming-Hua, Tan Bin-Bin, Chen Hai-Lei, Zhang Hui
Аннотация
BACKGROUND: Hepatocellular carcinoma (HCC) with advanced features such as Budd-Chiari syndrome, chronic liver failure and multiple intrahepatic metastases poses significant therapeutic challenges. Yttrium-90 (90Y) radioembolization is a locoregional treatment option with potential benefits in such complex cases. This case report explores the application of 90Y radioembolization in combination with systemic therapies, highlighting its potential role in managing advanced HCC.
CASE SUMMARY: A 51-year-old male presented with HCC characterized by massive intrahepatic lesions, multiple metastases, and chronic liver failure secondary to Budd-Chiari syndrome. The patient underwent 90Y radioembolization following hepatic arterial infusion chemotherapy and was subsequently combined with lenvatinib. Post-treatment follow-up revealed a significant reduction in tumor size, with the maximum diameter decreasing from 142.45 mm to 73.16 mm over six months. Liver function improved from Child-Pugh class B to A. However, new intrahepatic lesions emerged at ten months, and liver function deteriorated to Child-Pugh class C. The patient survived for 18 months after initial diagnosis.
CONCLUSION: Yttrium-90 radioembolization combined with systemic therapies demonstrated significant tumor regression and temporary liver function improvement in a patient with advanced HCC, suggesting its potential as a treatment option in complex cases.
CASE SUMMARY: A 51-year-old male presented with HCC characterized by massive intrahepatic lesions, multiple metastases, and chronic liver failure secondary to Budd-Chiari syndrome. The patient underwent 90Y radioembolization following hepatic arterial infusion chemotherapy and was subsequently combined with lenvatinib. Post-treatment follow-up revealed a significant reduction in tumor size, with the maximum diameter decreasing from 142.45 mm to 73.16 mm over six months. Liver function improved from Child-Pugh class B to A. However, new intrahepatic lesions emerged at ten months, and liver function deteriorated to Child-Pugh class C. The patient survived for 18 months after initial diagnosis.
CONCLUSION: Yttrium-90 radioembolization combined with systemic therapies demonstrated significant tumor regression and temporary liver function improvement in a patient with advanced HCC, suggesting its potential as a treatment option in complex cases.