The non-surgical treatments of hepatocellular carcinomas in a patient with severe hemophilia A

We recently treated a patient with multiple hepatocellular carcinomas (HCC) who had severe hemophilia A and thrombocytopenia secondary to cirrhosis. He was not a candidate for surgery because of his liver failure. Transcatheter arterial chemoembolization and percutaneous ethanol injection therapy were successfully performed without complications by maintaining factor VIII levels above 40%. We believe that the non-surgical treatment of HCC can be performed safely in patients with coagulation disorders, by the appropriate administration of coagulation factors, despite thrombocytopenia and/or elongation of the prothrombin time from cirrhosis.