春名 克純¹, 川崎 俊彦¹, 上尾 太郎¹, 柴峠 光成¹, 井谷 智尚¹, 三村 純¹, 小森 英司¹, 藤堂 彰男¹, 内田 浩也², 東 貞之², 橋本 公夫³

Yoshisumi HARUNA¹, Toshihiko KAWASAKI¹, Tarou UEO¹, Mitsushige SHIBATOGE¹, Toshinao ITANI¹, Jun MIMURA¹, Hideshi KOMORI¹, Akio TODO¹, Hiroya UCHIHDA², Sadayuki AZUMA², Kimio HASHIMOTO³

¹西神戸医療センター消化器内科, ²西神戸医療センター腹部超音波室, ³西神戸医療センター病理科

¹Gastroenterology Division Nishi-Kobe Medical Center, ²Abdominal Ultrasound Service Nishi-Kobe Medical Center, ³Pathology Division Nishi-Kobe Medical Center

キーワード : Chronic renal failure, Hepatocellular carcinoma, Intervensional ultrasonography, Percutaneous hot saline injection therapy

A 76-year-old man was admitted to this institution for further evaluation and treatment of a large solitary hepatic tumor that been detected incidentally by abdominal ultrasonography. The patient had suffered chronic renal failure. Blood urea nitrogen of 51 mg/dl and serum creatinine of 4.8 mg/dl ruled out CT and angiography for evaluation of the tumor. Ultrasound guided needle biopsy of the tumor yielded moderately differentiated hepatocellular carcinoma cells. Although serological markers for the hepatitis C virus were positive, GOT and GPT were normal, and he did not have liver cirrhosis. However, his other medical problems, including old myocardial infarction, angina pectoris, abdominal aortic aneurysm, old cerebral hemorrhage, and chronic renal failure, made it difficult to subject him to surgery. We thus performed percutaneous hot saline injection therapy (PHoT). Tumor size was remarkably reduced after four sessions, and he was released from the hospital. We conclude that PHoT may be useful in the treatment of large hepatocellular carcinomas.