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Published byLizbeth Green Modified over 6 years ago
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Successful TACE followed by OLT for HCC in Alcoholic Cirrhosis
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History of Present Illness
63 y/o male 3 year history of end stage liver disease secondary to alcohol (since abstinent) Referred for management of HCC 8.5 cm liver lesion AFP of 12,526 (June 2006)
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Past Medical History Cirrhosis – EtOH HCC Diabetes Mellitus type 2
Encephalopathy Grade 2 varices No ascites HCC Diabetes Mellitus type 2 Ischemic cardiomyopathy – EF 40% Asthma Vitiligo
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Investigations Hg 12.5, Plt 32, INR 1.54 AST 45, ALT 50, Alk P 53
TB 1.3, Alb 2.6, Cr 0.9 MELD 12
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Treatment – June 2006 Chemoembolization with cisplatin
Long acting octreotide Bevacizumab
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Follow-up September AFP 3.5 Negative PET scan CT-abdomen …
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June September 2006
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Liver Transplant Evaluation
Cardiac evaluation cleared for liver transplant Worsening MELD, listed for OLT Transplanted February 1, 2007 Explant: 3cm necrotic area, no tumor 4 year post OLD no recurrence
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