case_images: PMC10461443_01
case_images: Contrast-enhanced ultrasound (CEUS) images and digital subtraction arteriogram (DSA) during TACE (A) CEUS in the arterial phase shows hyperenhancement of the mass [(A) arrow]; (B) The mass shows washout in the portal venous phase of CEUS [(B) arrow]; (C) pre-embolization DSA of the mass, black arrow represents tumor blush; (D) post-embolization DSA was repeated and demonstrated no residual enhancing tumor.
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case_images: PMC10461443_01_fmed-10-1231597-g001.jpg
case_images: fig1
case_images: Contrast-enhanced ultrasound (CEUS) was also performed (Figures 1A,B). Oncology Group Performance Score 0. Our patient with liver-dominant disease and with limited lymph node metastases, transarterial chemoembolization (TACE) was performed according to the ISMIO treatment guidelines (Figures 1C,D).
case_images: Abdominal enhanced computed tomography images (A) Plain CT scan; (B) arterial phase of contrast-enhanced CT; (C) portal vein phase of contrast-enhanced CT. CT examination of the abdomen show no biliary obstruction and disease progression of intrahepatic lesions.
case_images: fmed-10-1231597-g002.jpg
case_images: PMC10461443_01_fmed-10-1231597-g002.jpg
case_images: fig2
case_images: Contrast-enhanced computed tomography of the abdomen, which excluded biliary obstruction and disease progression of the intrahepatic lesions (Figure 2), suggested the presence of a stone in the upper left ureter with dilatation of the upper ureter.
case_images: Changes of various indicators after hospitalization. (A-C) Trend of clinical indicators; (D) trend of severity scores.
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case_images: PMC10461443_01_fmed-10-1231597-g003.jpg
case_images: fig3
case_images: The patient's liver function improved and he felt relief from the abdominal distension and weakness (Figures 3A-C). At last, the patient's Chronic Liver Failure Consortium (CLIF-C) ACLF score was calculated to be 71, and the model for the end-stage liver disease (MELD) score was 48, indicating an unfavorable outcome (Figure 3D). Ascitic fluid tests suggested ascites infection.