Shao MH, Tan BB, Chen HL, Zhang H. Yttrium-90 radioembolization for advanced hepatocellular carcinoma with Budd-Chiari syndrome: A case report. World J Clin Oncol 2025; 16(5): 104762 [DOI: 10.5306/wjco.v16.i5.104762]
Corresponding Author of This Article
Hui Zhang, Chief Physician, Department of Hepatobiliary Surgery, First Affiliated Hospital of Third Military Medical University (Army Medical University), No. 30 Gaotanyan Main Street, Shapingba Distirct, Chongqing 400038, China. 13637912611@163.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ming-Hua Shao, Bin-Bin Tan, Hai-Lei Chen, Hui Zhang, Department of Hepatobiliary Surgery, First Affiliated Hospital of Third Military Medical University (Army Medical University), Chongqing 400038, China
Author contributions: Zhang H, Shao MH, and Tan BB conceptualized the paper, wrote the abstract, introduction, and case presentation sections of the paper, and created the literature review table; Zhang H, Shao MH, and Chen HL contributed to the case discussion; Zhang H provided essential input in reviewing the manuscript for important intellectual content, and supervised and assisted with the final editing; and all authors thoroughly reviewed and endorsed the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui Zhang, Chief Physician, Department of Hepatobiliary Surgery, First Affiliated Hospital of Third Military Medical University (Army Medical University), No. 30 Gaotanyan Main Street, Shapingba Distirct, Chongqing 400038, China. 13637912611@163.com
Received: January 8, 2025 Revised: March 4, 2025 Accepted: April 22, 2025 Published online: May 24, 2025 Processing time: 131 Days and 23.6 Hours
Abstract
BACKGROUND
Hepatocellular carcinoma (HCC) with advanced features such as Budd-Chiari syndrome, chronic liver failure and multiple intrahepatic metastases poses significant therapeutic challenges. Yttrium-90 (90Y) radioembolization is a locoregional treatment option with potential benefits in such complex cases. This case report explores the application of 90Y radioembolization in combination with systemic therapies, highlighting its potential role in managing advanced HCC.
CASE SUMMARY
A 51-year-old male presented with HCC characterized by massive intrahepatic lesions, multiple metastases, and chronic liver failure secondary to Budd-Chiari syndrome. The patient underwent 90Y radioembolization following hepatic arterial infusion chemotherapy and was subsequently combined with lenvatinib. Post-treatment follow-up revealed a significant reduction in tumor size, with the maximum diameter decreasing from 142.45 mm to 73.16 mm over six months. Liver function improved from Child-Pugh class B to A. However, new intrahepatic lesions emerged at ten months, and liver function deteriorated to Child-Pugh class C. The patient survived for 18 months after initial diagnosis.
CONCLUSION
Yttrium-90 radioembolization combined with systemic therapies demonstrated significant tumor regression and temporary liver function improvement in a patient with advanced HCC, suggesting its potential as a treatment option in complex cases.
Core Tip: This case report highlights the successful combination of yttrium-90 radioembolization therapy and lenvatinib in treating a patient with advanced hepatocellular carcinoma characterized by large tumors, multiple intrahepatic metastases, and Budd-Chiari syndrome complicated by chronic hepatic failure. Despite the complexity of the case, this treatment approach effectively reduced tumor burden, improved liver function, and significantly prolonged the patient’s survival, offering a promising therapeutic option for similar challenging scenarios.
