Microwave Ablation in the Thermal Treatment of Hepactocellular Carcinoma: Case Report

I. Koti, C. Jioua, A. Benhamdane, R. Chaibi, S. Hdiye, T. Addajou, S. Mrabti, F. Rouibaa, H. Seddik
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Abstract

Hepatocellular carcinoma (HCC) stands as one of the most prevalent malignant tumors [1], and is the cause of over one million deaths annually worldwide [2]. While surgical resection remains the preferred treatment for early-stage hepatocellular carcinoma (HCC) in well-compensated cirrhosis patients, thermal ablation techniques offer a credible non-surgical option. Their minimal invasiveness, high tolerability, safety, established efficacy in local disease control, virtually unlimited repeatability, and cost-effectiveness render them valuable alternatives. Microwave ablation (MWA) of HCC appears to be a safe and effective treatment. Here we report a case of 53-year-old male, followed for hepatitis C complicated by compensated cirrhosis, During the follow up, Laboratory tests found liver function tests were eleveted, α-fetoprotein (AFP) was normal. Abdominal ultrasound showed a focal hepatic mass straddling segments VI and VIII, rounded, well-limited, with heterogeneous hyperechoic echostructure, and splenomegaly. Contrast-enhanced abdominal computed tomography showed a chronic liver desease with a focal lesion straddling segments VI and VIII, oval, tissue-like, hypodense in the center, measuring 50x41mm, with signs of early arterial enhancement consistent with HCC characteristics and signs of portal hypertension and a multicystic kidney. Hepatic MRI revealed a chronic liver disease straddling segments VII and VIII of a hepatic lesion measuring 23x 22mm classified as Li-RADS 4 with signs of portal hypertension and splenomegaly. Based on these results, the patient was diagnosed as HCC with well compensated cirrhosis, and in view of the fact that he had only a single lesion and was in functional grade A of Child-Pugh classification and staged as BCLC-A in the Barcelona Clinic Liver Cancer (BCLC) staging system, the patient benefited from microwave ablation for his HCC, with good clinical, biological and radiological evolution. Microwave Ablation (MWA) emerges ..........
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微波消融在肝细胞癌热疗中的应用:病例报告
肝细胞癌(HCC)是最常见的恶性肿瘤之一[1],每年导致全球超过 100 万人死亡[2]。虽然手术切除仍是肝硬化患者早期肝细胞癌(HCC)的首选治疗方法,但热消融技术提供了一种可靠的非手术疗法。热消融技术具有微创、耐受性高、安全、局部疾病控制疗效确切、可重复性几乎不受限制以及成本效益高等优点,因此是非常有价值的替代疗法。微波消融(MWA)似乎是一种安全有效的治疗方法。我们在此报告了一例 53 岁的男性患者,他因丙型肝炎并发代偿性肝硬化而接受随访,在随访期间,实验室检查发现肝功能检查无异常,α-胎儿蛋白(AFP)正常。腹部超声波检查显示,横跨第六和第八节段的局灶性肝包块,圆形,局限性好,伴有异质高回声回声结构,脾脏肿大。对比增强腹部计算机断层扫描显示,该病例为慢性肝病,病灶横跨第 VI 和第 VIII 节段,呈椭圆形,组织样,中心密度低,大小为 50x41mm,有符合 HCC 特征的早期动脉强化迹象,以及门脉高压和多囊肾的迹象。肝脏磁共振成像显示慢性肝病横跨第七和第八节段,肝脏病灶大小为 23x22mm ,被归类为 Li-RADS 4 级,并伴有门脉高压和脾脏肿大的迹象。鉴于患者仅有一个病灶,且在Child-Pugh分级中属于功能性A级,在巴塞罗那临床肝癌(BCLC)分期系统中属于BCLC-A级,因此患者接受了肝癌微波消融术,并取得了良好的临床、生物学和放射学进展。微波消融术(MWA)出现 ..........
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