In Reply to: Case 0100_05 -- Hepatocellular Carcinoma with Multifocal Simultaneous Adenomas posted by Editor on December 30, 1999 at 14:22:35:
I agree with your assessment and management. HCCA is frequently a multicentric process, and the underlying cirrhotic stroma is inherently premalignant especially in the presence of coexistant imagable lesions. The systemic toxicity and decrease in the functional hepatic reserve associated with chemoembolization were minimized due to the limited left lobe embolization undertaken. The choice of gelfoam powder (rather than the "permanent" 45 u Ivalon) was also appropriate for the same reasons.