Bland Hepatic Embolization of a Well-Differentiated Neuroendocrine Tumor

IO Learning: 2020;8:E62-E63.

Epub 2020 October 2.

Key words: bland embolization, interventional radiology

CASE STUDY

A 63-year-old woman presented with diarrhea and unintentional weight loss. Positron emission tomography (PET) and computed tomography (CT) of the abdomen and pelvis showed multiple hepatic metastatic lesions and a soft tissue mass along the terminal ileum. Liver biopsy confirmed a low-grade neuroendocrine tumor (antigen Ki-67, 1.9%). She was initiated on octreotide and everolimus. A few months later, a PET-CT scan with Gallium-68 dotatate radiotracer demonstrated a somatostatin-analog avid nodule projecting to the terminal ileum and multifocal sites of intense somatostatin-analog localization within both lobes of the liver consistent with hepatic metastases (Figures 1A and 2A; Video 1). Due to the patient’s progressive disease, she underwent bland hepatic embolization (Figure 1B) of the left lobe (Figure 2B; Video 2) using 250 micron Embozene microspheres (Varian Medical Systems) followed by right hepatic lobe bland embolization (Figure 2C; Video 3) using 250 micron Embozene microspheres a few months later. She then underwent resection of the primary site at the terminal ileum, and is now clinically asymptomatic.

From the University of Kentucky Markey Cancer Center, Lexington, Kentucky.

The authors report that patient consent was provided for publication of the images used herein. 

Disclosure: The authors have completed and returned the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors report no conflicts of interest regarding the content herein.

Address for Correspondence: Gaby E. Gabriel, MD, Assistant Professor of Radiology & Surgery, Program Director, Interventional Radiology Residency, Assistant Program Director, Diagnostic Radiology Residency, Faculty, Vascular & Interventional Radiology, University of Kentucky College of Medicine, 800 Rose Street, Room HX-322, Lexington, KY 40536-0293. Email: gaby.gabriel@uky.edu