Semin Liver Dis 2014; 34(04): 465-468
DOI: 10.1055/s-0034-1394145
Diagnostic Problems in Hepatology
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Histological Changes in Nontumoral Liver Secondary to Radioembolization of Hepatocellular Carcinoma with Yttrium 90-impregnated Microspheres: Report of Two Cases

Sadhna Dhingra
1   Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center, Houston, Texas
,
Myron Schwartz
2   Recanati-Miller Transplantation Institute, Mount Sinai Health System, New York, New York
,
Edward Kim
3   Department of Vascular and Interventional Radiology, Mount Sinai Health System, New York, New York
,
Huaibin Mabel Ko
4   The Lillian and Henry M. Stratton-Hans Popper Department of Pathology, Mount Sinai Health System, New York, New York
,
Stephen C. Ward
4   The Lillian and Henry M. Stratton-Hans Popper Department of Pathology, Mount Sinai Health System, New York, New York
,
M. Isabel Fiel
4   The Lillian and Henry M. Stratton-Hans Popper Department of Pathology, Mount Sinai Health System, New York, New York
,
Swan N. Thung
4   The Lillian and Henry M. Stratton-Hans Popper Department of Pathology, Mount Sinai Health System, New York, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
04 November 2014 (online)

Abstract

Transarterial radioembolization (TARE) with yttrium-90 is a minimally invasive locoregional therapy for hepatocellular carcinoma (HCC), and involves selective delivery of glass or resin microspheres impregnated with radioactive yttrium-90 into small arteries preferentially supplying the tumor for tumoricidal effect thus sparing the nontumoral liver, or into lobar artery to induce atrophy and contralateral hypertrophy. Clinically, post-TARE a small proportion of cases develop radioembolization-induced liver disease. Histological changes of TARE on nontumoral liver parenchyma have not been well characterized. Herein, we report two cases of liver resections for HCC post-TARE, and describe the histological changes in nontumoral liver parenchyma.

 
  • References

  • 1 Llovet JM, Di Bisceglie AM, Bruix J , et al; Panel of Experts in HCC-Design Clinical Trials. Design and endpoints of clinical trials in hepatocellular carcinoma. J Natl Cancer Inst 2008; 100 (10) 698-711
  • 2 Hickey R, Vouche M, Sze DY , et al. Cancer concepts and principles: primer for the interventional oncologist-part I. J Vasc Interv Radiol 2013; 24 (8) 1157-1164
  • 3 Kennedy A, Nag S, Salem R , et al. Recommendations for radioembolization of hepatic malignancies using yttrium-90 microsphere brachytherapy: a consensus panel report from the radioembolization brachytherapy oncology consortium. Int J Radiat Oncol Biol Phys 2007; 68 (1) 13-23
  • 4 Wollner I, Knutsen C, Smith P , et al. Effects of hepatic arterial yttrium 90 glass microspheres in dogs. Cancer 1988; 61 (7) 1336-1344
  • 5 Wollner IS, Knutsen CA, Ullrich KA , et al. Effects of hepatic arterial yttrium-90 microsphere administration alone and combined with regional bromodeoxyuridine infusion in dogs. Cancer Res 1987; 47 (12) 3285-3290
  • 6 Sangro B, Gil-Alzugaray B, Rodriguez J , et al. Liver disease induced by radioembolization of liver tumors: description and possible risk factors. Cancer 2008; 112 (7) 1538-1546
  • 7 Gil-Alzugaray B, Chopitea A, Iñarrairaegui M , et al. Prognostic factors and prevention of radioembolization-induced liver disease. Hepatology 2013; 57 (3) 1078-1087
  • 8 Young JY, Rhee TK, Atassi B , et al. Radiation dose limits and liver toxicities resulting from multiple yttrium-90 radioembolization treatments for hepatocellular carcinoma. J Vasc Interv Radiol 2007; 18 (11) 1375-1382
  • 9 Vouche M, Lewandowski RJ, Atassi R , et al. Radiation lobectomy: time-dependent analysis of future liver remnant volume in unresectable liver cancer as a bridge to resection. J Hepatol 2013; 59 (5) 1029-1036
  • 10 Nalesnik MA, Federle M, Buck D, Fontes P, Carr BI. Hepatobiliary effects of 90yttrium microsphere therapy for unresectable hepatocellular carcinoma. Hum Pathol 2009; 40 (1) 125-134
  • 11 Ko HM, Ward SC, Facciuto M, Kim E , et al. Histologic comparison of non-tumor liver in hepatocellular carcinoma patients treated with yttrium-90 radioembolization and transcatheter arterial chemoembolization. Mod Pathol 2014; 27: 423A
  • 12 Fernandez-Ros N, Iñarrairaegui M, Paramo JA , et al. Radioembolization of hepatocellular carcinoma activates liver regeneration, induces inflammation and endothelial stress and activates coagulation. Liver Int 2014; [ epub ahead of print]
  • 13 D'Ascenzo S, Millimaggi D, Di Massimo C , et al. Detrimental effects of anabolic steroids on human endothelial cells. Toxicol Lett 2007; 169 (2) 129-136