Ablative radioembolization of hepatocellular carcinoma with total arterial supply originating from the superior adrenal artery achieved complete pathologic necrosis

Gonzalo Arotzarena; Beau B Toskich; Andrew R Lewis; Ricardo Paz-Fumagalli

doi:10.1016/j.radcr.2022.10.025

Ablative radioembolization of hepatocellular carcinoma with total arterial supply originating from the superior adrenal artery achieved complete pathologic necrosis

Radiol Case Rep. 2022 Nov 2;18(1):196-199. doi: 10.1016/j.radcr.2022.10.025. eCollection 2023 Jan.

Authors

Gonzalo Arotzarena^{1

2}, Beau B Toskich¹, Andrew R Lewis¹, Ricardo Paz-Fumagalli¹

Affiliations

¹ Mayo Clinic Florida, 4500 San Pablo Rd, Jacksonville, FL 32224, USA.
² Universidad de Navarra, Calle Irunlarrea 1, 31008, Pamplona, Navarra, Spain.

Abstract

Exclusively extrahepatic arterial perfusion to previously untreated, early-stage, hepatocellular carcinoma (HCC) is uncommon. We present a case of right superior adrenal artery completely supplying a subcapsular HCC in a 68-year-old male. The extrahepatic arterial territory targeted excluded structures potentially vulnerable to radiation, which allowed safe ablative Y-90 radioembolization that achieved complete pathological necrosis.

Keywords: Ablative radioembolization; Adrenal artery; Extrahepatic vascular supply; Hepatocellular carcinoma; Radiation segmentectomy.

Publication types

Case Reports