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Four patients with unresectable hepatic adenoma underwent selective hepatic artery embolization. Non-operability was related to the size and the situation of the tumor, and the clinical background. The only subsequent postembolization syndrome was one case of acute renal failure, reversible after diuretic treatment. In 3 cases the decrease in tumoral size was delayed and appeared six months after the first embolization, allowing surgical resection in 2 cases. Because of lack of tumoral devascularization and presence of residual nodules on the resected specimen, this technique is not a satisfactory alternative to surgery, at least with the employed technique. However, preoperative selective hepatic artery embolization can play an important role in the management of hepatic adenomas as it may permit safer surgical resection.

Iodized oil (lipiodol) injected into the hepatic artery is selectively retained by hepatocarcinomas, as demonstrated by computerized tomography (CT) performed one week after the injection. The value of this technique for the diagnosis of hepatocarcinoma was assessed in a retrospective study of 45 patients. In 39 per cent of the cases intrahepatic tumoral extension was determined by the iodized oil which showed tumoral nodules that had not been detected by conventional methods, such as ultrasonography and CT alone. The lesions revealed by the iodized oil were small nodules around the main tumour. The combined iodized oil-CT technique plays an important role in the choice of treatment, especially when surgical excision is contemplated. It might also contribute to an early diagnosis of hepatocarcinoma in patients at risk, as illustrated by four of our cases where conventional morphological examinations had been negative.