PERCUTANEOUS ETHANOL INJECTION THERAPY OF ADENOMATOUS HYPERPLASTIC NODULES IN CIRRHOTIC LIVER-DISEASE

Adenomatous hyperplastic nodules (AHNs) in cirrhotic liver are conside red a precancerous condition which may lead to hepatocellular carcinom a (HCC). In this study, we treated a total of 23 AHNs in 15 patients w ith percutaneous ethanol injection (PEI). The treatment included 6 to 8 PEIs, performed on an out-patient basis under sonographic guidance. A 22 G (0.7 mm) spinal needle was used. The total amount of alcohol de livered into each lesion was 8 to 25 ml (mean 14.9 ml). At the end of treatment, complete necrosis of the nodule was proved in all cases by multiple fine-needle biopsies and confirmed by CT and MR findings. Dur ing follow-up (9-41 months, mean 24 months) no recurrences were demons trated. However, HCC occurred elsewhere in the liver of 4 patients and additional AHNs were detected in 2 patients. Thus, PEI proved able to cause complete ablation of AHNs, presumably preventing their malignan t transformation. However, patients with AHN remain at high risk for d eveloping HCC.