Tumor-feeding arteries

Lipiodol (iodine combined with ethyl esters of fatty acids of poppyseed oil) is used in transcatheter arterial chemoembolization (TACE) in the treatment of heptocellular carcinoma. A mixture of lipiodol and a chemotherapeutic agent is injected into the tumor feeding artery. This procedure has been complicated by lipiodol brain embolization in a few cases. In a patient who developed a modest monoparesis of the right arm, with transient dysarthria and dizziness, during his fourth course of TACE, a CT scan showed multiple infratentorial and supratentorial lesions consistent with deposition of lipiodol [25An MRI scan showed multiple non-enhancing cortical and subcortical hyperintense lesions (FLAIR and DWI), which represented areas of reduced diffusion on DWI. The patient recovered completely over the next 48 hours and the MRI scan returned to almost normal after 1 month. 

SMANCS can be dissolved in aqueous media and administrated intravenously [96,97], or in lipids, and injected directly into the tumor-feeding artery (hepatic artery for hepatoma... 

We found that the NO-releasing agent isosorbide dinitrate (ISDN, Nitrol ) enhanced antitumor activity of SMANCS/Lipiodol when they were infused into the tumor-feeding bronchial artery of lung cancer using a catheter preceding to the infusion of SMANCS arterially. This ISDN infusion enhanced... 

AVMs are composed of a network of channels interposed between feeding arteries and draining veins, without any direct shunt. Two different anatomic types of nidus may be more or less differentiated compact nidus, constituting a tumor-like well-circumscribed network, and diffuse nidus, with sparse, abnormal AV channels spread within normal brain parenchyma (Chin et al. 1992). 

Angiography is no longer performed in the diagnostic workup of renal masses and is reserved for therapeutic interventions only. The study should start with an abdominal aortogram to determine the number and location of arteries supplying the kidney and the tumor. Selective catheterization and angiography of each feeding artery is performed to assess... 

Adenoma cells are arranged in cords and separated by sinusoids (Ishak 1994). The tumor lacks portal tracts or bile ducts, a key histological feature that helps distinguish hepatocellular adenoma from focal nodular hyperplasia (Boulahdour et al. 1993). Kupffer s cells are found in adenomas but probably they are often decreased in number or less functional than normal liver tissue, as reflected by absent or diminished uptake of technetium (Tc)-99m sulfur colloid (Fig. 10.1) (Rubin and Lichtenstein 1993). Because this neoplasm has no portal tracts, the tumor perfusion occurs solely by peripheral arterial feeders therefore the hypervascular nature of adenoma, related to sinusoids and feeding arteries, associated with poor connective tissue support, can lead frequently to hemorrhage. Because a tumor capsule is usually absent or incomplete, hemorrhage may spread into the liver or abdominal cavity (Molina and ScHiFF 1999). 

Another cause of abnormal liver enhancement can be seen in the arterial phase around highly vascularized liver neoplasms. In the dynamic study, the liver around a hypervascular neoplasm can be significantly hypodense compared to the remainder of the normal parenchyma since the iodinated arterial blood flow is strongly diverted to feed the hypervascular liver lesion. This phenomenon maybe seen around benign or malignant liver tumors, which are essentially dependent on the amount of arterial vascularization of the hepatic neoplasm (Fig. 11.18). The phenomenon is transitory and in the portal venous phase of liver enhancement it returns to iso density. 

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