Medullary Thyroid Carcinoma with Multiple Hepatic Metastases: Treatment with Transcatheter Arterial Embolization and Percutaneous Ethanol Injection.

Thirty-three consecutive patients with previously untreated hepatocellular carcinoma (HCC) and 6 patients with recurrent HCC were treated with transcatheter arterial embolization (TAE). The patients were not eligible for surgical resection or percutaneous ethanol injection. TAE was performed with Lipiodol Ultra-Fluid, epidoxorubicin and Gelfoam, with a mean of 1.7 treatments per patient. CT was performed 15 days after TAE. The mean cumulative survival was 14.2 months in patients with previously untreated HCC. The survival of patients stages Okuda I and II did not differ significantly (p > 0.05); tumor size did not affect survival (p > 0.05). Two patients with recurrent HCC died 7.0 and 9.3 months after the diagnosis of tumor recurrence; the remaining 4 patients are still alive with a maximum follow-up of 22.5 months from the diagnosis of HCC recurrence. Ten complications occurred in 8 patients, and were controlled by medical therapy. Eleven patients died during the study; no death was related to TAE. The series was not randomized, but comparison with the natural history of HCC suggests that TAE is effective as palliative treatment of advanced or recurrent HCC.

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The role of hepatic trans-arterial chemoembolization in metastatic medullary thyroid carcinoma: a specialist center experience and review of the literature

Acta Endocrinologica ◽

10.1530/eje-16-0960 ◽

2017 ◽

Vol 176 (4) ◽

pp. 463-470 ◽

Cited By ~ 7

Author(s):

S Grozinsky-Glasberg ◽

A I Bloom ◽

N Lev-Cohain ◽

A Klimov ◽

H Besiso ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Liver Metastases ◽

Medullary Thyroid Carcinoma ◽

Clinical Improvement ◽

Tumor Response ◽

Liver Volume ◽

Hepatic Metastases ◽

Case Series ◽

Medullary Thyroid ◽

Arterial Chemoembolization

BackgroundLiver metastases are relatively common in patients with metastatic medullary thyroid carcinoma (MTC), carrying a negative impact on disease prognosis. The options for selective therapy of liver metastases in MTC patients are limited to catheter-guided procedures such as trans-arterial chemoembolization (TACE). Data regarding the effectiveness and safety of this procedure in MTC are limited.AimTo explore the clinical outcome, survival and safety profile of TACE for liver metastases in a group of MTC patients.MethodsRetrospective case series of patients treated at a single tertiary University Medical Center from 2005 to 2015.ResultsSeven consecutive patients (mean age 64.5 ± 10.9 years, 5 females) with histologically confirmed MTC with liver metastases were included. Metastatic involvement of the liver was less than 50% of the liver volume in all patients. The median size of the largest liver lesion was 40 ± 6.9 mm. The patients underwent in total 20 sessions of TACE. Clinical improvement as well as tumor response (PR) were observed in all patients. The median time to tumor progression was 38 months (range 8–126). Three patients were still alive at the end of the follow-up period (a median overall survival rate of 57 ± 44 months).ConclusionTACE in MTC patients with hepatic metastases is usually well tolerated and induces both clinical improvement and tumor response for prolonged periods of time in the majority of patients. This therapeutic option should always be considered, irrespective of the presence of extrahepatic metastasis.

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