Transarterial embolization with bleomycin for symptomatic hepatic focal nodular hyperplasia

Diagn Interv Radiol. 2017 Jan-Feb;23(1):66-70. doi: 10.5152/dir.2016.16061.

Abstract

Purpose: We aimed to evaluate the therapeutic effect and safety of transarterial embolization using bleomycin-iodinated oil and polyvinyl alcohol particles for the treatment of symptomatic hepatic focal nodular hyperplasia (FNH).

Methods: This retrospective study included 23 consecutive patients with symptomatic hepatic FNH, who underwent embolization using bleomycin-iodinated oil and polyvinyl alcohol particles between January 2005 and December 2012. Patients were followed-up with radiologic and clinical evaluation. Therapeutic effects including changes in lesion size and symptomatic improvement were evaluated after the procedure.

Results: Embolization was performed for 27 lesions in 23 patients. Follow-up period ranged from three months to 89 months. The mean lesion diameters decreased significantly from 5.0±2.4 cm to 3.2±1.5 cm at 3-9 months after embolization (P < 0.001). Five lesions had complete resolution in the follow-up period. The clinical symptoms were significantly relieved in all patients. Contrast-enhanced scans at follow-up showed complete lack of residual arterial blood supply in the majority of lesions. Local recurrence was found in one treated lesion at the 54-month follow-up. There were no major complications associated with the procedure.

Conclusion: Transarterial embolization using bleomycin-iodinated oil and polyvinyl alcohol particles for hepatic FNH is a safe and effective alternative treatment with good long-term symptomatic control and reduction in lesion size after embolization.

MeSH terms

  • Adolescent
  • Adult
  • Bleomycin / administration & dosage*
  • Embolization, Therapeutic / methods*
  • Female
  • Focal Nodular Hyperplasia / diagnostic imaging
  • Focal Nodular Hyperplasia / pathology
  • Focal Nodular Hyperplasia / therapy*
  • Humans
  • Male
  • Polyvinyl Alcohol / administration & dosage
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult

Substances

  • Bleomycin
  • Polyvinyl Alcohol