Transarterial chemoembolization of hepatocellular carcinoma via extrahepatic collateral artery from a supraduodenal and cystic artery trunk, originating from the gastroduodenal artery: A case report

The outcome of transarterial chemoembolization for unresectable hepatocellular carcinoma (HCC) relies on the appropriate identification of tumor supplying arteries. HCC derives 90% of the blood supply from the hepatic arteries. However, depending on the tumor's size and location, the extrahepatic collateral artery (EHC) can develop and predominantly supply the tumor. The supraduodenal artery (SDA) arises from the gastroduodenal artery (GDA). On the other hand, the cystic artery (CA) mostly originates from the right hepatic artery. However, a common trunk of the SDA and CA originating from the GDA and feeding the HCC as an EHC has not been reported. We herein present a 76-year-old man with HCC in segment 6, supplied by an EHC from a common trunk of the SDA and CA originating from the GDA. Selective arteriography confirmed the EHC, which was successfully embolized with drug-eluting beads without complications.