Safety and efficacy of chemoembolization with mixture of bleomycin and lipiodol in the treatment of giant liver hemangiomas

Purpose: The aim of this study is to retrospectively investigate the safety and efficacy of use of Bleomycin and Lipiodol mixture in transarterial chemoembolization (TACE) performed to treat patients with giant liver hemangiomas in Çukurova University Radiology Deparment. Material and Methods: Twenty-one patients with a total of 24 giant liver hemangiomas treated with TACE using a mixture of Bleomycin and Lipiodol between October 2014 to January 2020 were included in this study. Dimension, volume and compression findings prior and after the procedure were recorded. Findings were statistically analysed with SPSS 20.0 package program (IBM Corp. Armonk, New York, USA). Findings: Twenty-four hemangiomas in 21 patients (14 [66,6%] female) were statistically investigated. Median age was 47 years (min-max: 35-69 years). Post-TACE median follow-up was 26,2 months (min-max: 5,5-48,5 monhts). In all but two patients, single session TACE was performed. Median dimension of giant hemangiomas was 96 mm (min-max: 41-120 mm) and 61 ml (min-max: 20-120 mm) before and after TACE respectively. Median volume was 240,79 ml (13,13-2628,62 ml) and 61 ml (3,02-831,16 ml) before and after TACE respectively. There was statistically significant reduction in both dimension and volume (p<0,01). There was no major complication. In three patients, self-limiting post-embolisation syndrome of three days duration was observed. Except for these three patients, hospitalization time was limited to 24 hours for all patients. Conclusion: In the treatment of giant liver hemangiomas, TACE using a Bleomycin and Lipiodol mixture is safe method with a low complication rate. Because of it provides significant shrinkage, it is a effective treatment in giant liver hemangiomas. It can be a major alternative treatment to patients who surgical treatment is not appropriate. Keywords: Liver, giant hemangioma, Bleomycin, Lipiodol, transarterial chemoembolization.