1Abdulmohsen Ahmed Alhussaini,1Yousof A AlZahrani, 1Yousof A AlZahrani

1National Guard Hospital

Background:

The Gulf nations were among the first in the world to implement the COVID-19 vaccination. Regional guidelines like MENACTRIMS endorse tA 57-year-old female known with liver cirrhosis presented with segment 4 subcapsular exophytic hepatocellular carcinoma. The patient underwent Transarterial chemoembolization three times with no significant response. A decision was made to switch to Transarterial Radioembolization as a bridging therapy for liver transplantation. Hepatic artery mapping showed tumoral blush supplied by the left internal mammary artery. Radioembolization was performed utilizing 0.72 GBq Y-90 SIR-sphere (SIRtex) via the left internal mammary artery. Three months later, a CT scan of the abdomen showed complete response of the tumor with post radioembolization changes. Parasitic supply to hepatocellular carcinoma lesions is reported in 17% of patients. The left internal mammary artery represents only 0.5% of the extrahepatic supply to tumors. While Transarterial chemoembolization approach to treat left internal mammary artery parasitic supply has been extensively reported in the literature, herein we report that Transarterial Radioembolization is a safe and feasible alternative to Transarterial chemoembolization for Hepatocellular carcinoma.

Material(s) and Method(s):

A 57-year-old female known with liver cirrhosis presented with segment 4 subcapsular exophytic hepatocellular carcinoma. The patient underwent Transarterial chemoembolization three times with no significant response. A decision was made to switch to Transarterial Radioembolization as a bridging therapy for liver transplantation. Hepatic artery mapping showed tumoral blush supplied by the left internal mammary artery. Radioembolization was performed utilizing 0.72 GBq Y-90 SIR-sphere (SIRtex) via the left internal mammary artery. Three months later, a CT scan of the abdomen showed complete response of the tumor with post radioembolization changes. Parasitic supply to hepatocellular carcinoma lesions is reported in 17% of patients. The left internal mammary artery represents only 0.5% of the extrahepatic supply to tumors. While Transarterial chemoembolization approach to treat left internal mammary artery parasitic supply has been extensively reported in the literature, herein we report that Transarterial Radioembolization is a safe and feasible alternative to Transarterial chemoembolization for Hepatocellular carcinoma.

Conclusion(s):

ThA 57-year-old female known with liver cirrhosis presented with segment 4 subcapsular exophytic hepatocellular carcinoma. The patient underwent Transarterial chemoembolization three times with no significant response. A decision was made to switch to Transarterial Radioembolization as a bridging therapy for liver transplantation. Hepatic artery mapping showed tumoral blush supplied by the left internal mammary artery. Radioembolization was performed utilizing 0.72 GBq Y-90 SIR-sphere (SIRtex) via the left internal mammary artery. Three months later, a CT scan of the abdomen showed complete response of the tumor with post radioembolization changes. Parasitic supply to hepatocellular carcinoma lesions is reported in 17% of patients. The left internal mammary artery represents only 0.5% of the extrahepatic supply to tumors. While Transarterial chemoembolization approach to treat left internal mammary artery parasitic supply has been extensively reported in the literature, herein we report that Transarterial Radioembolization is a safe and feasible alternative to Transarterial chemoembolization for Hepatocellular carcinoma.