Hepatic arterial embolisation in the treatment of the midgut carcinoid syndrome and other advanced endocrine tumours metastatic to the liver

K. Geterud, Ulf Tylen, S. Jansson, O. Stenqvist, L. E. Tisell, H. Ahlman

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Patients with the midgut carcinoid syndrome were treated with hepatic arterial embolisation subsequent to surgical debulking under protection of a somatostatin analogue to minimise the circulatory effects of vasoactive tumour products released. After completion of the ischaemic treatment the majority of patients were kept on a low dose of this drug for optimal palliation. Patients with recurrent symptoms in combination with a two-fold increse of 5-HIAA levels were considered for repeated embolisation. The combined ischaemic treatment and adjuvant medical therapy resulted in good symptomatic relief in all 17 patients treated during the last 5-year period. All these patients are today alive and in good general condition. The mean reduction of 5-HIAA levels by embolisation was 63 ± 3%. A similar treatment program, excluding the somatostatin analogue, was followed in three patients with disseminated endocrine pancreatic tumours and in four patients with medullary carcinomas of the thyroid. These patients had a less pronounced reduction of tumour markers. In all 43 embolisations were performed in 24 patients without any mortality. Five patients, all with the carcinoid syndrome, developed vascular or other complications at the target area following embolisation. Two of these patients required further interventional therapy; drainage of a hepatic abscess and resection of a hepatic arterial aneurysm. It is concluded that hepatic arterial embolisation is a safe procedure with high success rate resulting in good palliation and reduction of tumour markers. Repeat embolisation can often be performed for recurrence of symptoms.

Original languageEnglish (US)
Pages (from-to)69-76
Number of pages8
JournalJournal of Interventional Radiology
Issue number2
StatePublished - 1990
Externally publishedYes


ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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