Hepatic Necrosis after Trans-Arterial Embolization of Metastatic Neuroendocrine Tumour
  • Sarah Micallef
    Department of Medicine, Mater Dei Hospital, Msida, Malta
  • Kelvin Cortis
    Department of Radiology, Mater Dei Hospital, Msida, Malta
  • Claude Magri
    Department of Oncology, Sir Anthony Mamo Oncology Centre, Msida, Malta


Trans-arterial embolization, hepatic necrosis, carcinoid metastasis


Liver metastases from neuroendocrine tumours (NETs) are usually seen on cross-sectional imaging at presentation. In such cases, curative surgical resection is usually not possible given that most patients have bilobar disease. Various locoregional approaches are now widely available that enable local control of disease and management of systemic symptoms. These include trans-arterial embolization (TAE), trans-arterial chemoembolization (TACE), selective internal radiotherapy and thermal ablation.
We describe a rare case of hepatic necrosis after TAE in a 61-year-old woman with a metastatic NET. Cross-sectional imaging showed extensive necrosis affecting segments VII and VIII of the liver. This occurred secondary to thrombosis in the portal vein branches to these segments, confirmed on a Doppler ultrasound scan. The mechanism of portal vein thrombosis after TAE could be due to the presence of occult arterioportal anastomoses. These allow transit of the embolizing agents into the portal vein branches supplying the treated segments and subsequent thrombosis.



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    Published: 2020-03-19
    Issue: 2020: Vol 7 No 5 (view)

    How to cite:
    Micallef S, Cortis K, Magri C. Hepatic Necrosis after Trans-Arterial Embolization of Metastatic Neuroendocrine Tumour. EJCRIM 2020;7 doi:10.12890/2020_001530.