Abstract
We describe a 52-year-old female patient who presented with a 9.5-cm fibrolamellar hepatocellular carcinoma (FL-HCC). The patient was initially unsuitable for surgical resection and therefore underwent transarterial chemoembolization followed by selective internal radiation therapy (SIRT) with Yttrium-90 to downsize the tumour. Following SIRT, the tumour decreased in volume from 350 to 20 cm3 allowing curative (R0) resection with an extended left hepatectomy and reconstruction of IVC. This is the first reported case of FL-HCC treated with SIRT in which, due to the good SIRT response, the patient was downsized to allow curative resection.
Highlights
Fibrolamellar hepatocellular carcinoma (FL-HCC) is a rare variant of HCC
We describe a 52-year-old female patient who presented with a 9.5-cm fibrolamellar hepatocellular carcinoma (FL-HCC)
The patient was initially unsuitable for surgical resection and underwent transarterial chemoembolization followed by selective internal radiation therapy (SIRT) with Yttrium-90 to downsize the tumour
Summary
Fibrolamellar hepatocellular carcinoma (FL-HCC) is a rare variant of HCC. While the majority (70% of cases) present with resectable disease, for those who present with unresectable disease (20–30% of cases), there are limited treatment options with a 5-year survival between 0 and 5% and median survival of 12 months [1,2,3]. The patient was initially unsuitable for surgical resection and underwent transarterial chemoembolization followed by selective internal radiation therapy (SIRT) with Yttrium-90 to downsize the tumour. Following SIRT, the tumour decreased in volume from 350 to 20 cm3 allowing curative (R0) resection with an extended left hepatectomy and reconstruction of IVC. This is the first reported case of FL-HCC treated with SIRT in which, due to the good SIRT response, the patient was downsized to allow curative resection.
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