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Objective: Lenvatinib is considered the first-line treatment for unresectable advanced hepatocellular carcinoma (HCC); however, in some clinical cases, discontinuation of lenvatinib is unavoidable. It is important to elucidate if transcatheter arterial infusion (TAI) with drug-eluting beads transarterial chemoembolization (DEB-TACE) is a feasible second-line treatment after discontinuing lenvatinib. In this study, we aimed to evaluate the efficacy, hepatic function and nutritional status associated with TAI with DEB-TACE for patients who previously discontinued lenvatinib. Materials and Methods: We included 35 patients who were prescribed lenvatinib for unresectable HCC between July 2018 and December 2019, of whom 12 discontinued lenvatinib during the study. The changes in the albumin-bilirubin (ALBI) score and the controlling nutritional status (CONUT) score before and after discontinuing lenvatinib were examined. Furthermore, the tolerability and survival of patients treated using TAI with DEB-TACE as a second-line treatment were analysed. Results: The ALBI and CONUT scores were significantly worse when lenvatinib was started and stopped (p

Lenvatinib is approved as a standard systemic therapy for unresectable hepatocellular carcinoma (HCC) patients; however, experience with lenvatinib in clinical practice is insufficient. We present the case of a patient with advanced HCC whose prothrombin time - international normalized ratio (PT-INR) was elevated after cotreatment with lenvatinib and warfarin potassium. The patient was a 26-year-old man with congenital abnormalities who had to take warfarin potassium because he had a mechanical heart valve. He was diagnosed with unresectable HCC at 24 years old and was treated by transcatheter arterial chemoembolization and transcatheter arterial infusion. After some interventional radiology treatments, lenvatinib was started. After 4 days of treatment with lenvatinib and warfarin potassium, his PT-INR increased to 4.13, and the treatment had to be stopped. No changes were observed in other Child-Pugh score factors. The elevation in the PT-INR after cotreatment with lenvatinib and warfarin potassium was thought to be caused by pharmacological effects of concurrent use or pharmacological sensitivity to warfarin potassium in this patient with liver dysfunction. The PT-INR must be monitored when lenvatinib is given to advanced HCC patients taking warfarin potassium.

Concurrent radiotherapy with Transcatheter Arterial Infusion (TAI) chemotherapy is reportedly effective in curing locally advanced head and neck cancer. However, the effectiveness and safety of using TAI with palliative or salvage intent after radiotherapy combined with systemic intravenous chemotherapy (IV-CRT) is not well known. Herein, we describe two cases using TAI palliatively for locally advanced residual tongue cancer after IV-CRT, where tumor reduction or tumor progress inhibition could be achieved, thereby improving or maintaining the patients’ quality of life without severe toxicities. These cases indicate the effectiveness and safety of using TAI palliatively for locally advanced tongue cancer. Further, we have combined a literature review with the description of these cases. Keywords: tongue cancer; transcatheter arterial infusion; palliative interventional radiology

Background Patients with advanced body/tail pancreatic cancer have poor quality of life and low overall survival rate. In recent years, interventional diagnosis and treatment of advanced pancreatic cancer have become increasingly widespread. This retrospective cohort study investigated the efficacy of routine intravenous chemotherapy (the control group), transcatheter arterial infusion (TAI) chemotherapy, and TAI combined with radioactive particles as therapeutic methods for advanced body/tail cancer pancreatic by assessing the short-term and overall survival rates. Methods We screened our prospective database for patients with advanced body/tail pancreatic cancer, which tumor deemed unresectable and no other confirmed malignant tumors, patients were assigned into three groups according to their treatment. Analyses with regard to the clinical responses, the 6, 12, and 18-month survival rates and overall survival rates were performed. Results The median survival time was 6 months in the control group, 10 months in the TAI group and 13 months in the TAI combined group. The Kaplan–Meier estimates of the OS among the three groups, indicating that there is significant difference among three groups (P༜0.000). The clinical remission rates were 17.5% in the control group, 41.5% in the TAI group, and 48.0% in the TAI combined group. Covariates analyzed showed that different treatment methods and times affected the results significantly (P༜0.002). Conclusions In the treatment of advanced body/tail pancreatic cancer, TAI and TAI combined with radioactive particles significantly improved the clinical outcomes in patients compared with routine intravenous chemotherapy.

Objective To evaluate the clinical efficacy of infusion of gemcitabine (GEM) and fluorouracil (5-FU)through the celiac artery and superior mesenteric artery in the treatment of pancreatic carcinoma (PC). Methods We analyzed 20 patients diagnosed clinically or pathologically with PC, without metastases, who had an estimated survival duration of >3 months in our department from May 2009 to December 2014. Nine patients were treated directly without surgical resection of the tumor, while the other 11 patients were treated after surgery. In all patients, the femoral artery was punctured using the Seldinger technique, and a catheter was placed in the opening of the celiac artery or the superior mesenteric artery. We administered 500 ​mg/m2 GEM and 500 ​mg/m2 5-FU. Observational data included data on clinical efficacy and survival rates during the follow-up period of 3–72 months. Results Twenty patients were treated 85 times with transcatheter arterial infusion chemotherapy (TAI). The survival rates were 80%, 40%, 35%, 20%, 10%, and 5% at 3, 6, 12, 24, and 72 months, respectively. Conclusion TAI chemotherapy with GEM and 5-FU may be a therapeutic option for the treatment of PC.

The effectiveness of adjuvant transcatheter arterial chemo- or/and chemoembolization therapy after curative hepatectomy of initial hepatocellular carcinoma (HCC) is controversial. This study aimed to evaluate whether hepatectomy combined with adjuvant transcatheter arterial infusion therapy (TAI) for initial HCC has better long-term survival outcomes than hepatectomy alone. From January 2012 to December 2014, a prospective randomized controlled trial of patients with initial HCC was conducted. Then, 114 initial HCC patients were recruited to undergo hepatectomy with adjuvant TAI (TAI group, n = 55) or hepatectomy alone (control group, n = 59) at our institution. The TAI therapy was performed twice, at 3 and 6 months after curative hepatectomy (UMIN 000011900). The patients treated with TAI had no serious side effects, and operative outcomes did not differ between the two groups. No significant differences were found in the pattern of intrahepatic recurrence or time until recurrence between the two groups. Moreover, no significant differences were found in the relapse-free survival or overall survival. Low cholinesterase level (

Transcatheter arterial chemoembolization (TACE) is the standard therapy for Barcelona Clinic Liver Cancer (BCLC) classification intermediate stage B hepatocellular carcinoma (HCC). However, other transcatheter methods, such as transcatheter arterial infusion (TAI), also play an important role in the treatment of advanced HCC. Although it has been reported that TAI with a high concentration of a fine-powder formulation of cisplatin (DDP-H) reduced intrahepatic recurrence and improved survival, the combined use of TAI with DDP-H and TACE has not yet been investigated. The aim of this study was to evaluate which TACE chemotherapeutic agent in combination with DDP-H TAI contributes more to improved survival in BCLC-B HCC. Survival was analyzed in 55 patients who underwent DDP-H TAI and TACE for BCLC-B HCC. The patients were classified into two groups; Epirubicin was used as the TACE agent in 29 patients, whereas miriplatin was used in 26 patients. The cumulative survival rates at 1 and 2 years were 66.4 and 36.0% in the epirubicin and 95.8 and 61.30% in the miriplatin group, respectively. Survival time was significantly prolonged in the miriplatin group compared with that in the epirubicin group. Multivariate analysis identified Child-Pugh classification and up-to-seven criteria as factors affecting survival. In addition, the selection of miriplatin as the TACE chemoagent was the treatment factor that most significantly affected survival. Thus, double-platinum therapy with DDP-H TAI and miriplatin TACE may be a useful treatment strategy for improving survival in BCLC-B HCC patients.

Background: Spinal metastases are the most common type of metastatic bone tumors. Various therapeutic approaches have been used to treat spinal metastases, but traditional treatments are often limited and ineffective. Minimally invasive interventional technology has been successfully performed in the clinical setting. Objectives: This study is designed to evaluate the curative effect of spinal metastases treated by percutaneous vertebroplasty (PVP) and transcatheter arterial infusion/chemoembolization (TAI/TACE). Patients and Methods: A prospective study was performed for 18 consecutive patients with spinal metastases justified by imaging findings and pathology, including 12 men and 6 women, with the mean age of 64.56 ± 11.07 years (range, 50 - 90 years). All patients first underwent PVP and then TAI/TACE. The degree of pain relief was assessed with visual analogue scale (VAS) and WHO standard. The rating of the activity of daily life (ADL) was utilized to evaluate the quality of life. The activities of daily life (ADL) were evaluated with modified Barthel index system. The size of tumor and further bone invasion were evaluated three months after surgery. Results: We achieved a 100% success rate of all interventional operations. The effective rates of pain relief were respectively 94%, 94%, 89%, and 78% for one-day post-op, one-week post-op, one-month post-op, and three-months post-op. VAS for back pain was 7.7 ± 0.8, 5.3 ± 0.6, 3.4 ± 0.8, 2.0 ± 0.6, and 1.5 ± 0.6 for pre-operative, one-day post-op, one-week post-op, one-month post-op, and three-months post-op, respectively. The improvement of VAS was respectively 2.3 ± 0.6, 4.3 ± 0.9, 1.4 ± 0.8, and 1.8 ± 0.7. Preoperative and postoperative 3 months Barthel index was 45.3 ± 12.5 and 85.6 ± 14.2, respectively. There were significant difference in pain relief and the ability of daily life between pre-operation and post-operation time points (P < 0.05). There were no severe clinical or radiographic complications after interventions. Conclusion: PVP combined with TAI/TACE is a safe and effective technique for treatment of spinal metastases. PVP is effective for pain relief but has a limited antitumor effect, while TACE kills tumors more thoroughly compared to PVP. The combination of two therapies can make up for the shortcomings of each other and obtain definite effect, which markedly improves the patients’ living quality.

To evaluate the antitumor effects of miriplatin-lipidol suspension and emulsion.Fifty rabbits with VX2 liver tumors were randomly assigned to ten groups. Then, we prepared four types of mixtures: a suspension of lipiodol and miriplatin (ML), an emulsion of miriplatin dissolved with lipiodol and contrast medium (MLC) or saline (MLS), and saline alone (S). Ratios between lipiodol and contrast medium/saline volumes were 1:1/4, 1:1/2, 1:1, and 1:2 respectively. We used the same dose of miriplatin (2 mg/kg) and lipiodol (0.1 ml/kg) in each emulsion and suspension group. After intra-arterial infusion, the tumor growth rate was calculated, and sequential change of the plasma platinum concentration, the platinum concentration in the tumor and in surrounding normal liver tissue was also measured.Among the ten groups, the tumor growth rate was lower in MLC and MLS groups, and the difference between tumor treated with MLS emulsion (ratio 1:1/2) and ML suspension was significant (p = 0.02). The platinum concentration in the normal liver tissue was lower in MLS and MLC groups than in the ML group, and that in the tumor was higher in the MLS and MLC emulsion (ratio 1:1/2) groups.We suggest that miriplatin-lipiodol emulsion may be more effective than suspension.

Objective The aim of this study was to evaluate the efficacy of transcatheter arterial chemoembolization (TACE) combined with a Chinese compound preparation of ganfule on advanced hepatocellular carcinoma (HCC).

We have previously reported the clinical efficacy of water-in-oil-in-water (W/O/W) emulsions, particularly for non-selective transcatheter arterial infusion (TAI) therapy. W/O/W emulsions limit damage to normal hepatic parenchyma, because of their minimal embolic effect on peripheral arteries and slow release of anticancer agent. The purpose of this study was to evaluate the safety and effectiveness of ultraselective TAI (UTI) of a W/O/W emulsion for hepatocellular carcinoma (HCC).11 patients with Stage I-III small HCCs (5 cm) underwent UTI with a W/O/W emulsion at our institute. Response was assessed using the Response Evaluation Criteria in Solid Tumors. Disease-free survival time was estimated using the Kaplan-Meier method.All 10 patients, excluding a patient who underwent a hepatectomy after UTI, achieved complete response. The 6, 12 and 30 month cumulative disease-free survival rates for the 10 patients were 100%, 90% and 60%, respectively. The patient who underwent hepatectomy after UTI developed complete necrosis of the HCC and peritumoral non-tumorous liver parenchyma.UTI therapy using a W/O/W emulsion for patients with small HCCs results in a good local response.

症例1はアルコール性肝障害の78歳男性．肝S5/8に径30 mmの肝細胞癌としてはCT・MRI画像上非典型であり，右門脈と肝静脈に近接した腫瘍を認め，L3分画とPIVKA-IIの上昇もあった．腹部血管造影にて肝細胞癌と診断して，肝動脈化学療法を先行させラジオ波焼灼療法と経皮的エタノール注入療法を施行した．4カ月後より急速進展して右門脈前枝に腫瘍栓を認め，徐々に拡がり，9カ月後に永眠された．症例2はC型+アルコール性肝硬変の67歳男性．肝S6に径30 mmのCT画像上腫瘍の境界が不鮮明な右門脈後下区域枝に近接した肝細胞癌を認め，AFP・L3分画・PIVKA-IIのいずれも上昇していた．肝動脈化学療法を先行させラジオ波焼灼療法を施行した．4カ月後より急速進展して右門脈前後枝に腫瘍栓を認め，7カ月後に食道静脈瘤破裂をきっかけに肝不全が進行し，9カ月後に永眠された．肝細胞癌に対する治療は，腫瘍マーカーの経緯や各種画像診断により腫瘍の性状や局在を詳細に把握し，組織学的分化度や肉眼型・脈管浸潤の可能性など腫瘍の悪性度を推測して内科的治療か外科的治療かの治療方針を決定する必要がある．

アイエーコール®を用いた肝動脈化学療法（TAI）と肝動脈化学塞栓療法（TACE）が著効した多発肝細胞癌の1例を経験したので報告する．症例は65歳女性．慢性C型肝炎で経過観察中にS7単発肝細胞癌を指摘され，S7亜区域切除術が施行された．術後7カ月目に約20個の両葉多発再発を認めた．マイトマイシンCを用いたTACEを約2年6カ月で6回施行し，一時腫瘍は1個まで減少したが，その後TACEでコントロール不良となり，多発再発を来した．そこでアイエーコール®単剤によるTAIを行った．約2年6カ月で10回施行し，腫瘍の消失を確認した．最終投与6カ月後にS2の単発再発を認めたが，アイエーコール®によるTACEで治療可能であった．その後半年間再発は認めず，腫瘍マーカーも正常であり，著効と判定した．手術からの全経過は約7年であった．本例のようにアイエーコール®が劇的に奏効する例が知られており，その感受性を決定する腫瘍学的特性の解明が待たれる．

71歳女性．2000年3月，肝S2に約1 cm大の肝細胞癌を発症し，肝生検及び経皮的エタノール注入療法を行った．その後も肝細胞癌の再発を認めエピルビシンやマイトマイシンを用いた肝動脈化学塞栓術や経皮的肝局所療法（経皮的エタノール注入療法，経皮的マイクロ波凝固療法）を行ってきたにもかかわらず，両葉多発肝細胞癌と進行し左門脈にも腫瘍塞栓が出現したため,2005年2月より動注用シスプラチン（アイエーコール®）を用い約2年間で計6回の反復投与を行った．その後腫瘍は消失し，腫瘍マーカーも正常化した．経過中大きな副作用や合併症も認めず現在も外来にて経過観察中である．予後不良な門脈塞栓を伴う進行肝細胞癌に対しシスプラチンを用いた治療は今後も予後改善に寄与すると考える．

Hepatoblastoma is the most common malignant hepatic tumor in children. About 50% of the cases occur before the age of 18 months and almost all before the age of 2 years. We present an extremely rare case of hepatoblastoma in an 11-year-old girl, which was pathologically verified and treated twice with transcatheter arterial infusion combined with radical resection. To date she has been followed-up for 15 years and has shown normal development after the operation. She has received no chemotherapy or radiation and has displayed no evidence of metastatic or recurrent disease.

患者は62歳,女性.嚥下困難の精査により,食道癌肉腫と診断し,右開胸開腹食道亜全摘, 3領域リンパ節郭清および胸骨後胃管再建術を施行した.腫瘍は5型病変であり,組織学的に紡錘形細胞から成る肉腫と移行部分に連続した扁平上皮癌で構成されていた.免疫染色結果と併せ,“いわゆる癌肉腫”, MtLt5s型, pT2N3M0IM0, pStage IIIと診断した.術後FP療法を1クール実施したが, 1年後,肝外側区域に径20mmの転移巣が判明し,再建胃管との位置関係より切除困難と判断し, CDDP50mg, bolus肝動(day1)および5-FU1,000mg点滴静注(day 2-6)による肝動注化学療法を3クール実施した.再発確認から7ヵ月後に, CRと判定したが,後に再々発をきたし,再発確認後23ヵ月目に癌死した.食道の“いわゆる癌肉腫”は稀な疾患で,肝転移巣に対し動注化学療法が奏効したという報告は少ない.これらの観点から貴重な症例と考え,報告する.

症例は68歳の女性で, C型肝炎ウイルス陽性の肝硬変で経過観察中, 右下腹部腫瘤と肝腫瘍が発見された. 腹部CTで, 肝左葉と右腹直筋内に造影される腫瘍を認めた. 肝腫瘍に対し左・中肝動脈から, 右腹直筋内腫瘍に対し右下腹壁動脈から, エピルビシンとリピオドールの選択的動脈注入(TAI)を施行した. 約1か月後, 肝腫瘍は若干縮小, 腹直筋腫瘍は著明に縮小した. 肝腫瘍に対して, 肝予備能が不良で肝切除術よりTAIの追加治療が必要で, 腹壁欠損が軽度であることから, 腹直筋腫瘍切除術を施行した. 病理組織学的検索で腫瘍は大部分が壊死に陥っていたが, 残存していた腫瘍細胞から肝細胞癌の転移と診断した. 術後5か月で, 腹直筋転移の再発なく経過観察中である. 肝生検や経皮的エタノール局所療法などの経皮的穿刺の既往のない, 肝細胞癌の腹直筋転移は極めてまれで, 腹直筋転移巣に対する下腹壁動脈からのTAIは極めて有効であり, 文献的に自験例が第1例目であった.

Zinostatin stimalamer (SMANCS) is a lipophilic intra-arterial chemotherapeutic agent for hepatocellular carcinoma (HCC). In our previous study, transcatheter arterial infusion chemotherapy using SMANCS for HCC showed a response rate of 20%. In an effort to obtain a superior anti-tumor effect against HCC, we conducted a phase II study of transcatheter arterial embolization (TAE) using SMANCS and gelatin sponge in 50 chemotherapy-naive patients with HCC. Four milligrams SMANCS plus 4 ml lipiodol emulsion was injected into the hepatic artery, followed by an injection of gelatin sponge. The responses were evaluated by computed tomography (CT) 1 month after treatment and thereafter every 3–4 months. One patient (2%) showed complete response and 15 patients (30%) had partial response resulting in an overall response rate of 32% (16/50; 95% confidence interval 19–45%). In 33 patients (66%), the disease remained stable, and 1 patient (2%) showed progressive disease. In 35 patients (70%), the rate of necrotic area to whole tumor was more than 50% according to the evaluation method using lipiodol accumulation in CT. The 1-, 3- and 5-year survival rates were 90, 55 and 19%, respectively. Grade 3 hematological toxicity was observed as thrombocytopenia in 2 patients (4%). Grade 3 and 4 non-hematological toxicity (liver dysfunction) occurred in 17 (34%) and 7 patients (14%), respectively. TAE using SMANCS, which was well tolerated, may be an effective treatment for advanced HCC.

Highlights • Transcatheter arterial infusion effectively controlled a rapidly progressing recurrence of hepatocellular carcinoma with portal vein tumor thrombus that developed after radiofrequency ablation. This was followed by radical hepatic resection, which showed complete pathological response., Introduction We report a patient with a rapidly progressing recurrence of hepatocellular carcinoma (HCC) with a portal vein tumor thrombus after radiofrequency ablation of the original lesion, then treated with transcatheter arterial infusion. Radical hepatic resection demonstrated a complete pathological response. Presentation of case A 60-year old male with alcoholic cirrhosis and gastric varices was diagnosed with HCC measuring 12 mm in segment 8. He underwent laparoscopic radiofrequency ablation, but recurred three months later. The lesion progressed rapidly and the right portal vein was occluded. He then underwent transcatheter arterial infusion with miriplatin and iodized oil, which was effective in reducing the size of the main lesion and portal vein tumor thrombus. Right anterior sectionectomy was then performed. Pathologically, there were no viable HCC cells in either the main lesion or the portal vein thrombus. He is alive two years and nine months after surgery without recurrence. Discussion A rapidly progressing HCC recurrence with portal vein tumor thrombus is usually associated with a poor prognosis. No effective treatments have been reported in this situation except hepatic resection. In this patient the tumor was effectively reduced after three courses of transarterial miriplatin and subsequent radical hepatic resection. This is the first report to achieve a complete pathological response for such an aggressive recurrence after initial radiofrequency ablation. Conclusion This strategy may result in long-term survival of patients with rapidly progressing recurrent HCC with portal vein thrombus, and further study is warranted.

This report describes a 58-year-old female with adenosquamous carcinoma (ASC) of the liver presenting with right lower abdominal pain. In most ASC of the liver, surgery is the first choice of treatment. However, surgery often seems to be ineffective because of the aggressive behaviour of this disease. At surgical laparotomy in the present case, there was a large tumour occupying the entire right lobe of the liver and invading the diaphragm. Thus, partial hepatectomy was performed. For the residual tumour, we performed repeated transcatheter arterial infusion chemotherapy with degradable starch microspheres (DSM). After four sessions of transcatheter arterial infusion chemotherapy, tumour size decreased remarkably and tumour markers had also decreased. Despite the poor prognosis, the patient remains alive and well 12 months after laparotomy. It is suggested that minimally invasive transcatheter infusion chemotherapy with DSM can be an effective treatment preserving a high quality of life.

This is a case report on pancreatic metastases from small cell lung cancer successfully treated by transcatheter arterial infusion of chemotherapy. The patient showed partial regression of pancreatic and thoracic disease. To our knowledge this is the first reported case of small cell lung cancer with pancreatic involvement treated with the transcatheter arterial infusion procedure; it represents an example of integrated treatments that may be considered for patients with pancreatic involvement from small cell lung cancer even if heavily pretreated.

Transcatheter arterial infusion chemotherapy (TAI) using a combination of iodized oil (lipiodol) and degradable starch microspheres (DSMs) has been reported to be superior to TAI with either lipiodol or DSMs separately for the treatment of hepatocellular carcinoma (HCC), based on the results of a prospective randomized study. In the study reported here, we investigated the predictors influencing response and survival in HCC patients receiving TAI using lipiodol and DSMs.A total of 50 HCC patients [Child-Pugh A/B, 34/16 patients; maximum tumor size 2.9 cm (mean); tumor number5/≥5 = 29/21 patients] were administered a mixture of cisplatin and lipiodol, followed by the injection of DSMs.According to the criteria of the Liver Cancer Study Group of Japan, the response [complete response (CR) + partial response (PR)] rate and CR rate were 72 and 38%, respectively [CR, 19 patients; PR, 17; stable disease, 9; progressive disease, 5]. The 1-, 2-, 3-, and 4-year cumulative survival rates were 85, 67, 41, and 35%, respectively, and the median survival time was 32.6 months. Multivariate analysis identified tumor number5 nodules [odds ratio 10.651, 95% confidence interval (CI) 2.168-52.317; P = 0.004] as an independent predictor of response and des-γ-carboxyprothrombin level100 mAU/mL [hazard ratio (HR), 0.268, 95% CI 0.091-0.786, P = 0.017] and therapeutic effect CR or PR (HR 0.255, 95% CI 0.099-0.659; P = 0.005) as independent predictors of survival.Transcatheter arterial infusion chemotherapy using lipiodol and DSMs might be considered as a potential intervention in HCC patients, especially those with tumors of5 nodules.

肝細胞癌手術の術前と術後に, リピオドール-抗癌剤懸濁液動注療法 (L-TAI) をおこなった, 絶対的非治癒切除例を除く肝切除耐術例34例の予後規定因子を検討した.そのうち11例 (32%) に再発を認めた.その無再発生存率は, 1年, 91%, 3年, 68%, 5年, 45%であった.L-TAIによる80%以上の腫瘍内壊死, 腫瘍径5cm以下, 組織学的被膜浸潤なし (fc-inf (-)) そして組織学的門脈侵襲なし (vp (-)) などの各因子は, 有意に予後に良い影響を与えた.被膜浸潤の有無にかかわらず, 3cm以下の腫瘍の5年無再発生存率は100%であった, さらにfc-inf (-) 例やfc-inf (+) 例のそれぞれにおいて, 壊死率の高いほど, また腫瘍径が小さいほど, 再発までの期間は延長した.

Summary Primary aldosteronism due to an adrenocortical adenoma can be cured by ablation of the adenoma, which produces an excess of aldosterone (aldosteronoma). This has traditionally been performed by surgical removal of the adenoma. However, some patients with aldosteronomas refuse surgical removal. Therefore, we developed a therapeutic method to ablate an aldosteronoma by transcatheter arterial infusion of ethanol. This method ablated the aldosteronoma in 27 (82%) of 33 treated cases and produced no serious complications, and may be one of the therapeutic choices for aldosteronomas.