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. 2000;10(2):81–86. doi: 10.1055/s-2000-7274

Successful Removal of a Giant Skull Base Metastasis from Hepatocellular Carcinoma after Direct Ethanol Injection

Case Report

Toshihiko Isaka, Hidemitsu Nakagawa, Tsuyoshi Suzuki, Junji Yamada, Kouichi Wada, Tsuyoshi Kadota
PMCID: PMC1656754  PMID: 17171106

Abstract

Skull metastases from hepatocellular carcinoma (HCC) are extremely rich in vascularity, which sometimes makes surgery dangerous. For minimally invasive surgery, it is very important to diminish the intratumoral vascular flow preoperatively. We report the case of a 69-year-old man with a giant skull base metastasis from HCC that was successfully removed after two sessions of direct ethanol injection into the tumor as a preoperative treatment to diminish the intratumoral vascular flow. Direct ethanol injection is a modification of percutaneous ethanol injection therapy, which is widely used in the treatment of primary HCC. In this article, we describe in detail the practical procedures and the usefulness of this treatment for a giant skull base metastasis from HCC.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Burgener F. A., Steinmetz S. D. Treatment of experimental adenocarcinomas by percutaneous intratumoral injection of absolute ethanol. Invest Radiol. 1987 Jun;22(6):472–478. doi: 10.1097/00004424-198706000-00005. [DOI] [PubMed] [Google Scholar]
  2. Duong D. H., Rostomily R. C., Haynor D. R., Keles G. E., Berger M. S. Measurement of tumor resection volumes from computerized images. Technical note. J Neurosurg. 1992 Jul;77(1):151–154. doi: 10.3171/jns.1992.77.1.0151. [DOI] [PubMed] [Google Scholar]
  3. Isaka T., Yoshimine T., Fujimoto K., Masuzawa M., Maruno M., Hayakawa T., Nakatani S. Direct ethanol injection for skull metastasis from hepatocellular carcinoma. The techniques and consequences of a therapeutic trial. Neurol Res. 1998 Dec;20(8):737–741. doi: 10.1080/01616412.1998.11740593. [DOI] [PubMed] [Google Scholar]
  4. Kim M., Na D. L., Park S. H., Jeon B. S., Roh J. K. Nervous system involvement by metastatic hepatocellular carcinoma. J Neurooncol. 1998 Jan;36(1):85–90. doi: 10.1023/a:1005716408970. [DOI] [PubMed] [Google Scholar]
  5. Kuratsu J., Murakami M., Uemura S., Ushio Y. Brain and skull metastases of hepatic or pancreatic cancer--report of six cases. Neurol Med Chir (Tokyo) 1990 Jul;30(7):476–482. doi: 10.2176/nmc.30.476. [DOI] [PubMed] [Google Scholar]
  6. Livraghi T., Bolondi L., Lazzaroni S., Marin G., Morabito A., Rapaccini G. L., Salmi A., Torzilli G. Percutaneous ethanol injection in the treatment of hepatocellular carcinoma in cirrhosis. A study on 207 patients. Cancer. 1992 Feb 15;69(4):925–929. doi: 10.1002/1097-0142(19920215)69:4<925::aid-cncr2820690415>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  7. Murakami R., Korogi Y., Sakamoto Y., Takhashi M., Okuda T., Yasunaga T., Nishimura R., Yoshimatsu S. Skull metastasis from hepatocellular carcinoma. CT, MR and angiographic findings. Acta Radiol. 1995 Nov;36(6):597–602. [PubMed] [Google Scholar]
  8. Redvanly R. D., Chezmar J. L., Strauss R. M., Galloway J. R., Boyer T. D., Bernardino M. E. Malignant hepatic tumors: safety of high-dose percutaneous ethanol ablation therapy. Radiology. 1993 Jul;188(1):283–285. doi: 10.1148/radiology.188.1.8390070. [DOI] [PubMed] [Google Scholar]
  9. Shiina S., Tagawa K., Niwa Y., Unuma T., Komatsu Y., Yoshiura K., Hamada E., Takahashi M., Shiratori Y., Terano A. Percutaneous ethanol injection therapy for hepatocellular carcinoma: results in 146 patients. AJR Am J Roentgenol. 1993 May;160(5):1023–1028. doi: 10.2214/ajr.160.5.7682378. [DOI] [PubMed] [Google Scholar]
  10. Shiina S., Tagawa K., Unuma T., Takanashi R., Yoshiura K., Komatsu Y., Hata Y., Niwa Y., Shiratori Y., Terano A. Percutaneous ethanol injection therapy for hepatocellular carcinoma. A histopathologic study. Cancer. 1991 Oct 1;68(7):1524–1530. doi: 10.1002/1097-0142(19911001)68:7<1524::aid-cncr2820680711>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
  11. Yakes W. F., Krauth L., Ecklund J., Swengle R., Dreisbach J. N., Seibert C. E., Baker R., Miller M., VanderArk G., Fullagar T. Ethanol endovascular management of brain arteriovenous malformations: initial results. Neurosurgery. 1997 Jun;40(6):1145–1154. doi: 10.1097/00006123-199706000-00005. [DOI] [PubMed] [Google Scholar]
  12. Yen F. S., Wu J. C., Lai C. R., Sheng W. Y., Kuo B. I., Chen T. Z., Tsay S. H., Lee S. D. Clinical and radiological pictures of hepatocellular carcinoma with intracranial metastasis. J Gastroenterol Hepatol. 1995 Jul-Aug;10(4):413–418. doi: 10.1111/j.1440-1746.1995.tb01593.x. [DOI] [PubMed] [Google Scholar]
  13. Yoshida D., Chen M. N., Awaya S., Nakazawa S. Cranial metastasis of hepatocellular carcinoma in a female--case report. Neurol Med Chir (Tokyo) 1993 Dec;33(12):839–844. doi: 10.2176/nmc.33.839. [DOI] [PubMed] [Google Scholar]

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