Yttrium-90 radioembolization for advanced hepatocellular carcinoma with Budd-Chiari syndrome: A case report

Figure 1 Imaging characteristics of the patient. A: Enhanced computed tomography showed a 142.45 mm exophytic hepatocellular carcinoma located at left medial lobe of the liver with multiple intrahepatic metastases at initial diagnosis; B: The distribution of yttrium-90 microspheres within tumors; C: After a single session of hepatic arterial infusion chemotherapy, the tumor size measured 134.55 mm, which decreased a little; D: Four months post-treatment, the target tumor size declined to 105.07 mm progressively. Visible areas of necrosis increased. The maximum diameter of the viable lesion reduced to 82.65 mm; E: Six months post-treatment, the target tumor shrank notably with the maximum diameter of the viable tumor measuring 7316 mm, gradually growing necrosis areas, but little enlargement of non-target intrahepatic lesions; F: Ten months post-treatment, the target lesion continues to shrink in size, and the liver volume has increased. However, multiple new nodular lesions have emerged within the liver. Figures 1A-F primarily illustrate the changes in size and tumor viability of the target lesion; G and H: The diameter changes of measurable non-target lesions before treatment and at the last follow-up visit, indicating significant reductions; I: The hollow arrows indicate the multiple small nodular lesions that newly appeared within the liver at the time of the last computed tomography scan.