Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2018; 24(37): 4291-4296
Published online Oct 7, 2018. doi: 10.3748/wjg.v24.i37.4291
Cerebral lipiodol embolism related to a vascular lake during chemoembolization in hepatocellular carcinoma: A case report and review of the literature
Hideki Ishimaru, Minoru Morikawa, Takayuki Sakugawa, Ichiro Sakamoto, Yasuhide Motoyoshi, Yohei Ikebe, Masataka Uetani
Hideki Ishimaru, Minoru Morikawa, Department of Radiology, Nagasaki University Hospital, Nagasaki 852-8501, Japan
Takayuki Sakugawa, Department of Radiology, University of the Ryukyus, Okinawa 903-0213, Japan
Ichiro Sakamoto, Department of Radiology, Nagasaki Harbor Medical Cancer, Nagasaki 850-8555, Japan
Yasuhide Motoyoshi, Department of Gastroenterology, Nagasaki Harbor Medical Cancer, Nagasaki 850-8555, Japan
Yohei Ikebe, Masataka Uetani, Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
Author contributions: Ishimaru H, Morikawa M, and Sakamoto I designed the report; Sakugawa T and Motoyoshi Y collected the patient’s clinical data; Ishimaru H, Ikebe Y, and Uetani M wrote the paper.
Informed consent statement: Consent was obtained from relatives of the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: 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:
Correspondence to: Minoru Morikawa, MD, Assistant Professor, Department of Radiology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
Telephone: +81-95-8197354 Fax: +81-95-8197357
Received: July 16, 2018
Peer-review started: July 16, 2018
First decision: August 1, 2018
Revised: August 4, 2018
Accepted: August 24, 2018
Article in press: August 24, 2018
Published online: October 7, 2018
Core Tip

Core tip: Vascular lakes that resemble extravasation within hepatocellular carcinomas occasionally emerge during chemoembolization. To date, the drainage routes from vascular lakes are not well understood. We present a patient with a recurrent large hepatocellular carcinoma in which a vascular lake emerged during conventional chemoembolization, draining into systemic veins and causing pulmonary and cerebral lipiodol embolism.