Tumor calcification and sustained complete response after chemoembolization in hepatocellular carcinoma - Two case reports and review of literature

Sep 28, 2026

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BACKGROUND: Transarterial chemoembolization (TACE) is widely used for unresectable hepatocellular carcinoma (HCC), and although rarely curative, selected patients may achieve complete radiological response with prolonged survival. Post-treatment tumoral calcification is uncommon in HCC and is rarely reported after drug-eluting beads TACE (DEB-TACE). CASE SUMMARY: Two patients with large solitary HCCs (>5 cm) received DEB-TACE and achieved complete radiological response after two sessions; after about 1 year peripheral tumoral calcification progressed, and both maintained remission over 6 years with preserved liver function. CONCLUSION: Peripheral calcification may indicate late effective tumor necrosis and durable treatment response, warranting prospective prognostic studies.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Background

Case summary

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Introduction

| W | J | G | O | World Journal of
Gastrointestinal Oncology | | --- | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastrointest Oncol 2025 December 15; 17(12): 113341 DOI: 10.4251/wjgo.v17.i12.113341 ISSN 1948-5204 (online) CASE REPORT Tumor calcification and sustained complete response after chemoembolization in hepatocellular carcinoma: Two case reports and review of literature Sultan R Alharbi Specialty type: Oncology Provenance and peer review: Unsolicited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade B, Grade C, Grade C Novelty: Grade B, Grade B, Grade B Creativity or Innovation: Grade B, Grade B, Grade B Scientific Significance: Grade A, Grade B, Grade C P-Reviewer: Cui P, PhD, Senior Scientist, China; Jia KF, PhD, China; Li DH, MD, Chief Physician, Professor, China Received: August 22, 2025 Revised: September 22, 2025 Accepted: October 13, 2025 Published online: December 15, 2025 Processing time: 111 Days and 9.8 Hours Sultan R Alharbi, Interventional Radiology Unit/Department of Radiology and Medical Imaging, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia Corresponding author: Sultan R Alharbi, MD, Associate Professor, Interventional Radiology Unit/Department of Radiology and Medical Imaging, College of Medicine, King Saud University, PO Box 7805, King Abdullah Street, Riyadh 11362, Saudi Arabia. [drsultan000@gmail.com](drsultan000@gmail.com) Abstract BACKGROUND Transarterial chemoembolization (TACE) is a widely accepted palliative therapy modality for unresectable hepatocellular carcinoma (HCC) . Although it is rarely curative, complete radiological response can be achieved in selected patients, leading to prolonged survival. Post-treatment tumoral calcification is an uncom-mon imaging finding in HCC and is rarely reported after drug-eluting beads TACE (DEB-TACE) . CASE SUMMARY Two patients with large, solitary HCCs (> 5 cm) were treated with DEB-TACE, and both achieved complete radiological response after two treatment sessions. Approximately 1 year after DEB-TACE, imaging demonstrated progressive peripheral tumoral calcification. Over 6 years of follow-up, both patients remained inremission with preserved liver function. CONCLUSION These two cases highlight the potential for complete remission and long-term survival in selected patients with large HCC following DEB-TACE. The appearance of peripheral calcification may represent a late imaging marker of effective tumor necrosis and durable treatment response although prospective studies are warranted to clarify its prognostic value. Key Words: Hepatocellular carcinoma; Transarterial chemoembolization; Drug-eluting beads chemoembolization; Complete response; Remission; Tumoral calcification; Case report ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved. WJGO [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 15, 2025 Volume 17 Issue 12 Alharbi SR. Complete remission and calcification of HCC Core Tip: Tumoral calcification following transarterial chemoembolization (TACE) for hepatocellular carcinoma is a rare imaging finding, and its clinical significance remains unclear. This case report describes 2 patients with large hepatocellular carcinoma who developed complete radiological response after drug-eluting beads TACE, followed by progressive peripheral calcification and sustained disease-free survival for 6 years. The notable association between post-TACE calcification and long-term remission raises the possibility that calcification may serve as a late imaging biomarker of effective tumor necrosis and durable treatment response. Citation: Alharbi SR. Tumor calcification and sustained complete response after chemoembolization in hepatocellular carcinoma: Two case reports and

FAQs

What clinical setting does the article address for hepatocellular carcinoma?

It focuses on unresectable hepatocellular carcinoma treated with transarterial chemoembolization, specifically drug-eluting beads TACE (DEB-TACE). The report highlights complete radiological response and subsequent post-treatment tumoral calcification.

How were the two cases treated and what imaging outcome was observed?

Two patients with large solitary HCCs (>5 cm) were treated with DEB-TACE, achieving complete radiological response after two treatment sessions. About one year later, progressive peripheral tumoral calcification appeared on imaging.

What is the proposed significance of peripheral tumoral calcification after DEB-TACE?

The article suggests peripheral calcification may serve as a late imaging marker of effective tumor necrosis and durable treatment response. It also notes that prospective studies are needed to clarify prognostic value.

Sep 28, 2026

Uploaded by Stanford