Sloughing of intraductal tumor thrombus of hepatocellular carcinoma after transcatheter arterial chemoembolization.

Transcatheter arterial chemoembolization (TACE) is effective for hepatocellular carcinoma (HCC) with intrabile duct thrombus. After TACE, intraductal tumor thrombi occasionally detach from the intrahepatic tumor and drop into the bottom of the common bile duct, causing clinical symptoms similar to the impaction of choledocholithiasis. The investigators describe three cases of sloughing of HCC intraductal tumor thrombi after selective TACE. In each of the three cases, the necrotic tumor cast was successfully removed endoscopically, and the patient's symptoms were dramatically improved. Two patients survived without recurrence of the intraductal tumor thrombus for 8 and 11 months after TACE, respectively.