A case of successful treatment with radiotherapy of hepatocellular carcinoma with portal vein tumor thrombus in secondary hemochromatosis due to myelodysplastic syndrome (2nd report)

We report a case of successful treatment by radiotherapy of hepatocellular carcinoma (HCC) with portal vein tumor thrombus. A 67-year-old man, suffering from secondary hemochromatosis due to myelodysplastic syndrome (MDS), had undergone partial hepatectomy 3 times and radiofrequency ablation (RFA) twice for HCC. CT scan 5 months after the second RFA revealed the recurrence of HCC (S4) with tumor thrombus in the umbilical portion. Since the patient had pancytopenia and bleeding tendency because of MDS and liver cirrhosis, it was difficult to perform fixed standard therapy and radiotherapy was therefore chosen. The radiotherapy was extremely effective, and the tumor including tumor thrombus was undetectable by CT scan after the radiotherapy. Although evidence for the effectiveness of radiotherapy for HCC has not been established, some reports suggested the efficacy of radiotherapy for HCC. Therefore, radiotherapy should be considered positively in cases for which any standard therapies for HCC cannot be indicated.