Long-Term Survival of a Patient with Hepatocellular Carcinoma under Treatment with Viscum album – Case Report

Hepatocellular carcinoma (HCC) is the most common liver neoplasm in dogs and can be treated by the Viscum album therapy in a curative or palliative way. The objective is to report a hepatocellular carcinoma case in a dog treated by homeopathic therapy, extending to Palliative Care, with a 24-month survival. A 12-year-old Schnauzer male with a history of a liver nodule was treated by intravenous and subcutaneous applications of V. album in different dynamization and combinations, chromotherapy, and oral homeopathic medicines. The tumor growth was controlled, and the health condition of the patient was stable while the medication was given as prescribed. However, as application frequency was reduced, tumor growth increased, and health deterioration was verified. Nevertheless and contrary to expectations, the patient had a 24-month survival. Therefore, these findings point to the potential of V. album on enhancing the quality of life, controlling tumor growth, and prolonging survival on patients with HCC. Patients under continuous treatment would benefit better of these properties.

Regression of multiple hepatocellular adenomas after cessation of oral contraceptive pills : a case report and review of the current literature

Hepatocellular adenoma (HCA) is an uncommon benign liver neoplasm usually solitary and identified incidentally on imaging. We report a case of a 50-year old female who was diagnosed with multiple hepatic adenomas of the inflammatory subtype. After discontinuation of oral contraception a decrease of both the number and size of the liver lesions was seen on magnetic resonance imaging (MRI) without the need of further intervention. The major challenge in the clinical management of patients with multiple HCAs resides in the risk assessment for future complications. In the case of multiple HCAs subtype seemed to be more relevant than the actual number of lesions. Because little is known about the natural evolution in patients with multiple HCAs, we performed a review of the current literature with focus on the different subtypes and their clinical relevance.

Endoluminal Cooling of the Esophagus during Percutaneous Thermal Ablation for Juxtaesophageal Liver Neoplasm: Two Cases

Thermal injury to the surrounding hollow organs should be avoided during thermal ablation therapy. Although this type of injury is rare, severe complications, such as perforation or stricture, have been reported. Despite the development of various adjunctive thermoprotection techniques, there are a few reports of their use for protecting the esophagus during liver ablation therapy. Endoluminal irrigation is a well-known technique for protecting hollow organs, such as the biliary tract, renal pelvis, ureter, and rectum; however, it is used infrequently for avoiding thermal injury to the esophagus. There may be hesitation in treating juxtaesophageal liver tumors with conventional ultrasound-guided ablation because the location restricts the ultrasonic window due to the poor visibility. We successfully treated two consecutive cases of juxtaesophageal liver tumor with computed tomography-guided ablation by applying endoluminal irrigation and cooling via a 12-French nasal feeding tube placed in the lower esophagus.

Resection of a Giant Hepatocellular Adenoma Causing Refractory Hypertension, Stroke, Hyperkalemia, Malnutrition and Mesenteric Ischemia

Hepatocellular adenoma is a rare, benign liver neoplasm. Hepatocellular adenomas carry a risk of malignant transformation and spontaneous bleeding, and giant hepatic adenomas can cause additional morbidity by compressing important adjacent structures. Surgical resection is recommended for large adenomas and is curative. We report a case of a 31-year old Hispanic male with a giant 35cm hepatocellular adenoma causing right lung compression/collapse, pulmonary hypertension, mesenteric ischemia, refractory hypertension, and cerebrovascular accident (CVA) due to renal vein compression. Exploratory laparotomy, median sternotomy, left lobectomy, cholecystectomy and hepatico-jejunostomy were performed. The giant adenoma was successfully removed with the resolution of all associated medical problems and a full recovery. Massive liver lesions can be resected safely with adequate exposure and may require median sternotomy. Multiple medical problems due to compression can be completely reversed with resection of these benign but giant lesions. Enucleation of giant adenomas is an acceptable form of treatment for lesions causing multiple symptoms due to compression and leads to a cure in most cases.