A 75-year-old man from Yemen with advanced liver cancer underwent a complex minimally invasive procedure after earlier treatments failed to stop the disease from progressing.The patient had been living with hepatitis C-related liver cirrhosis and was diagnosed with hepatocellular carcinoma, the most common type of primary liver cancer. The tumour, measuring nearly 7 cm, was located in the right lobe of the liver. According to the hospital, the patient travelled to India after facing limited access to advanced treatment options in Yemen.Before arriving in India, he had received immunotherapy and transarterial chemoembolization (TACE), a procedure in which chemotherapy is delivered directly into the blood vessels feeding a liver tumour. However, the tumour continued to grow, and blood tests showed persistently high tumour marker levels, suggesting that the cancer was continuing to progress.After evaluation, doctors recommended transarterial radioembolization (TARE), also known as Yttrium-90 (Y-90) radioembolization. The procedure involves injecting microscopic radioactive beads into the arteries supplying the tumour, allowing radiation to target cancer cells while limiting exposure to surrounding healthy liver tissue.According to the treating team, the procedure was complicated because the patient’s previous treatments had completely blocked the main artery supplying blood to the tumour. As a result, doctors could not use the conventional route to reach the cancer.Instead, the interventional radiology team accessed the tumour through a small collateral blood vessel connected to the superior mesenteric artery, which normally supplies blood to the intestine. The doctors said navigating through these tiny vessels took nearly three hours before they were able to position the catheter and deliver the Yttrium-90 treatment.A PET-CT scan performed after the procedure showed that the radioactive particles had been distributed throughout the tumour, indicating successful delivery of the treatment.The patient was discharged on the same day. According to the hospital, follow-up assessments showed a decline in tumour marker levels, and he has been recovering well.Commenting on the case, Dr Dheeraj Shyam V N, Consultant in Interventional Radiology at Aster Whitefield Hospital, said the procedure was technically challenging because the tumour’s primary blood supply had been blocked during earlier interventions. He explained that the team had to identify and use a small collateral vessel to access the tumour and deliver the Y-90 therapy. He added that post-procedure imaging confirmed good uptake of the radioactive particles within the tumour.Dr Dheeraj also said radioembolization is a minimally invasive treatment that does not require large surgical incisions or general anaesthesia, allowing many patients to return home the same day. He noted that the procedure may be considered for selected patients with advanced liver cancer when conventional treatment options have not been effective.

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