Transcatheter arterial chemoembolization followed by immediate radiofrequency ablation for large solitary hepatocellular carcinomas

Figure 2 A male patient aged 42 years with poorly differentiated hepatocellular carcinoma. Computed tomography (CT) scan showed a residual lesion in the liver after first interventional therapy with α-fetoprotein (345 μg/mL). Thus, transcatheter arterial chemoembolisation combined with radiofrequency ablation (RFA) was performed. A: CT scan showed a large solitary tumor in the right hepatic lobe before interventional therapy (arrow); B: A lipiodol deposit appeared around the liver tumour after the first procedure. CT revealed an enhanced residual lesion in the artery phase (arrow); C: Hepatic artery angiogram before RFA showed staining of the residual lesion around the lipiodol in the liver (arrow); D, E: A multipolar probe with a maximum extended diameter of 5 cm, which could cover the residual lesion, was designed to perform RFA in the region labelled by lipiodol and the original lesion (lipiodol deposition area). A diaphragmatic dome was involved, and the puncture tunnel detoured the lung tissue under the fluoroscope (arrow); F, G: The hepatic lesion was well controlled, and no recurrence was found after 15 mo follow-up (arrow).