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Figure 4d. HCC exclusively supplied by the right IPA in a 58-year-old man. (a) Arterial phase dynamic CT scan shows a hypervascular mass (*) in the posterior portion of the right hepatic lobe. Note the hypertrophied ascending portion of the right IPA (arrow). (b) Selective celiac angiogram from the first session of TACE shows no definitive tumor staining. We concluded that the feeding vessel might be the right IPA because of the tumor location directly adjacent to the posterior diaphragm, the hypertrophied right IPA, and the absence of tumor staining at celiac angiography. Dynamic CT showed that the right IPA originated from the right renal artery; therefore, aortography for detection of the right IPA was not performed. (c) Selective angiogram obtained via the right IPA (arrow), which originates from the right renal artery, shows hypervascular tumor staining (*). The intercostal artery (arrowhead) arising from the right IPA is the feeding vessel for the HCC. (d) Radiograph obtained after embolization of the right IPA shows the compact HCC (*) laden with iodized oil.
