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肝細胞癌頭蓋転移に対するエタノール注入療法：井阪俊彦¹, 吉峰俊樹², 丸野元彦², 藤本研治³, 中川秀光¹（¹大阪成人セ脳外, ²阪大脳外, ³国立大阪病院消内）

Ethanol injection therapy for skull metastasis from hepatocellular carcinoma -a first clinical trial-: Toshihiko ISAKA¹, Toshiki YOSHIMINE², Motohiko MARUNO², Kenji FUJIMOTO³, Hidemitu NAKAGAWA¹ (¹Dept. Neurosurg. Osaka Med. Center for Cancer & Cardiovascular Disease, ²Dept. Neurosurg. Osaka Univ. Med. Sch., ³Dept. Gastroenterology Natl. Osaka Hosp.)

The frequency of skull metastasis from hepatocellular carcinoma (HCC) is increasing along with the recent progress in the management of the primary lesion. Those patients are often complicated with poor general conditions or metastasis to other organs, and not readily indicated for surgery. We thought a direct injection of ethanol to the skull lesion could be one of the therapeutic options to cope with this troublesome situation. To evaluate the feasibility of this technique, we planned a therapeutic trial in a patient with HCC who was complicated with lumbar and skull metastasis, the latter metastasis repeated twice during the past one year. A total of 10 ml of ethanol was injected into the skull metastasis percutaneously under ultrasound (US) guidance. He transiently complained of local pain at the injection site, but not complicated with other adverse effects. Four days after the injection, the lesion was resected by surgery, which confirmed the pathologic diagnosis as well as the nearly-total necrosis of the tumor. This technicuqe is simple, safe and repeatable with low cost. We believe this technique can be an important option in the treatment of skull metastasis from HCC, especially, in patients with poor general condition or advanced stages of malignancy.