Transarterial embolization with bleomycin-lipiodol emulsion: a successful minimal invasive approach for giant liver hemangioma.

Hemangiomas are most common benign liver tumor. Most patients have an excellent prognosis because of the small size and benign nature of tumor. On some occasions, giant liver hemangioma may cause symptoms and significant challenges due to its complication. We report a case of giant liver hemangioma treated with minimal invasive approach by transarterial embolization (TAE). Following three TAE sessions over a specific timeframe, the patient was successfully managed, addressing that TAE may be a useful alternative to hepatic surgery in such cases.

Isolated pancreatic tuberculosis with splenic tuberculosis mimicking lymphoma malignum: A case report.

Tuberculosis is an endemic disease in certain parts of the world. This disease typically presents in the lungs, but it may also appear within the abdomen, such as in the pancreas. There can be challenges in diagnosing isolated pancreatic tuberculosis as it may mimic other diseases radiologically. We present a 33-year-old female with intermittent abdominal pain and weight loss. Chest x-rays showed normal findings while noncontrast abdominal computed tomography (CT) showed a solid cystic mass in the pancreas and in the spleen. Contrast-enhanced CT showed an inhomogeneous cystic mass in the body and tail of the pancreas with peripheral rim enhancement. A laparotomy procedure was performed, and tuberculosis was confirmed histopathologically. In this case report, we highlight the challenging nature of diagnosing isolated pancreatic and splenic tuberculosis due to its presentation, which is similar to other neoplastic processes.

Simple anthropometric measures to predict visceral adipose tissue area in middle-aged Indonesian men.

The diagnosing of central obesity requires ethnic-specific cut-offs of waist circumference (WC) and body mass index (BMI). This study aims to develop formulas to predict visceral adipose tissue (VAT) area based on WC and BMI to determine the cut-off points of central obesity in Indonesia. We conducted a cross-sectional study among 32 middle-aged Indonesian men. VAT area was measured using an abdominal CT scan, whereas WC and BMI were assessed through anthropometric measurements. Linear regression analysis was performed to define the formulas to predict VAT area using WC and BMI. Next, the optimal cut-off values of WC and BMI were determined using ROC curve analysis. Strong positive correlations were found between WC and VAT as well as BMI and VAT (r = 0.78; r = 0.67, p <0.001). The formula to predict VAT area from WC was -182.65 + (3.35 × WC), whereas the formula to predict VAT area from BMI was -57.22 + (6.95 × BMI). These formulas predicted WC of 88.5 cm and BMI of 23.9 kg/m2 as the optimal cut-off values for central obesity in middle-aged Indonesian men.

Hepatocellular Carcinoma with Macroscopic Fat Metamorphosis: A Case Series.

Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related deaths in the world, with hepatitis B and C as its main causes. HCC can have fat metamorphosis which leads to a better prognosis, though this is more commonly found in lesions smaller than 3 cm in diameter, and usually contains intravoxel fat. In this case series, we present three cases of HCC with macroscopic fat metamorphosis as examined using CT scan and MRI. Macroscopic fat is seen using CT as a hypodense mass with attenuation of -10 to -100 HU, or MRI using fat-saturation technique. Intravoxel fat can be seen on MRI using fat saturation chemical shift technique, appearing as signal loss during opposed phase and increased signal during in-phase. The differential diagnoses of HCC with fat metamorphosis are angiomyolipoma, hepatic adenoma, nodular steatosis, focal nodular hyperplasia, dysplastic nodule, liposarcoma, and hepatic metastasis. Enhancement patterns of the fat and non-fat component; intra-tumoral fat distribution; the presence of cirrhosis; the presence of atoll sign; and history of viral hepatitis are useful clues for differentiation of HCC with other differential diagnoses.

Complete Remission after Sequential Therapy of Drug Eluting Beads Transarterial Chemoembolization and Liver Resection in Large Solitary Nodule Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is the fifth most prevalent and the second highest cause of death among cancer. The treatment of large solitary nodule HCC is still challenging. Transarterial chemoembolization (TACE) and liver resection are two modalities of therapy in HCC management. However, recurrence rate from each therapy is relatively high. We report a case of 46-year-old man diagnosed with large solitary nodule HCC, who was treated with drug eluting bead TACE (DEB-TACE) prior to liver resection. Studies about this combination are still limited and showed various results.