Hepatic Necrosis after Trans-Arterial Embolization of Metastatic Neuroendocrine Tumour

Micallef, Sarah and Cortis, Kelvin and Magri, Claude (2020) Hepatic Necrosis after Trans-Arterial Embolization of Metastatic Neuroendocrine Tumour. European Journal of Case Reports in Internal Medicine, 7 (5). ISSN 2284-2594

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Abstract

Liver metastases from neuroendocrine tumours (NETs) are usually seen on cross-sectional imaging at presentation. In such cases, curative surgical resection is usually not possible given that most patients have bilobar disease. Various locoregional approaches are now widely available that enable local control of disease and management of systemic symptoms. These include trans-arterial embolization (TAE), trans-arterial chemoembolization (TACE), selective internal radiotherapy and thermal ablation. We describe a rare case of hepatic necrosis after TAE in a 61-year-old woman with a metastatic NET. Cross-sectional imaging showed extensive necrosis affecting segments VII and VIII of the liver. This occurred secondary to thrombosis in the portal vein branches to these segments, confirmed on a Doppler ultrasound scan. The mechanism of portal vein thrombosis after TAE could be due to the presence of occult arterioportal anastomoses. These allow transit of the embolizing agents into the portal vein branches supplying the treated segments and subsequent thrombosis.

Item Type: Article
Uncontrolled Keywords: Trans-arterial embolization, hepatic necrosis, carcinoid metastasis
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale)
Depositing User: Chiara D'Arpa
Date Deposited: 24 Nov 2020 14:02
Last Modified: 24 Nov 2020 14:02
URI: http://eprints.bice.rm.cnr.it/id/eprint/20088

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