HEPATOCELLULAR-CARCINOMA AFTER INTRAVENOU S THORIUM-X TREATMENT

Twelve years after receiving radiation therapy with thorium X (280 mu Ci) for long-standing Bekhterev's disease (ankylosing spondylitis) a 5 2-year-old man was found, by ultrasonography and computed tomography, to have a round mass, 11 x 12 cm, in the left lobe of the liver. Lapar oscopy discovered coarse, discoloured nodes on the surface of the righ t and left lobes of the liver which histologically showed hepatocellul ar carcinoma. There were no known risk factor for liver carcinoma (lik e cirrhosis, positive hepatitis B serology, alcohol abuse, haemochroma tosis or alpha(1)-antitrypsin deficiency). As exploratory laparotomy f ound the tumour to be inoperable, 15 chemotherapeutic embolizations we re performed. An abdominal wall metastasis was resected after 17 month s. At the time of this report, 20 months after the diagnosis was first made, the patient is in a poor general condition. - Internal radiothe rapy with thorium X was used, all else having failed, in the treatment of severe ankylosing spondylitis. Although it is not possible to prov e a direct causal relationship between the thorium X radiation and dev elopment of a liver carcinoma, the coincidence is remarkable.