Illustration of HIFU treatment on liver cancer with a chest wall hernia

HIFU for Liver Cancer: A New Hope or a Risky Procedure?

Beau Callahan in Health & Wellness December 2025 • 4 min read.

"Exploring the benefits and potential complications of High-Intensity Focused Ultrasound (HIFU) in treating advanced liver cancer"

Liver cancer, or hepatocellular carcinoma (HCC), ranks among the most prevalent and deadly cancers globally. Often, it's diagnosed at an advanced stage when the patient's liver function is already compromised, leaving many without the option of surgery. For these individuals, treatments like transcatheter arterial chemoembolization (TACE), targeted drugs, and radiofrequency ablation (RFA) offer some hope, but they come with their own limitations, like being unsuitable based on the size or location of the tumor.

High-Intensity Focused Ultrasound (HIFU) has emerged as a promising alternative. HIFU is a localized thermal ablation therapy known for being minimally invasive, promoting quicker recovery, and enhancing the body’s immune response against the tumor. It allows for precise, three-dimensional treatment of solid tumors, making it a valuable option for those with advanced HCC.

A recent case study sheds light on the potential of HIFU in treating unresectable, massive HCC. While the treatment demonstrated effectiveness, it also led to an unusual complication: a chest wall hernia. This article explores the details of this case, offering insights into the benefits and risks associated with HIFU therapy for liver cancer.

The Case Study: Promising Results with an Unexpected Twist

Illustration of HIFU treatment on liver cancer with a chest wall hernia

In September 2010, a 57-year-old male was admitted with complaints of abdominal distension. His medical history included a 30-year battle with hepatitis B, which had gone largely untreated. Scans revealed a significant mass in the right lobe of his liver, suspected to be HCC, along with intrahepatic metastasis, cirrhosis, splenomegaly, and portal hypertension. His alpha-fetoprotein (AFP) levels, a marker for liver cancer, were alarmingly high at 3,200 ng/ml.

Following an unsuccessful attempt at hepatic arterial infusion chemotherapy due to severe side effects, and the patient's inability to afford other targeted treatments like sorafenib, HIFU therapy was proposed. Over the course of the treatment, the lesion was carefully ablated using real-time ultrasound guidance. The settings were Treatment power 400 W, line scan 3 mm/sec and scanning distance 5 mm, the number of irradiations were 3. Treatment length, 4 h; irradiation time, 4,850 sec; treatment intensity, 1,212 kJ; total energy therapy, 1,940,000 J; and treatment volume, 11.43 cm³.

Tumor Regression: Follow-up scans showed a significant reduction in tumor size.
Pain Relief: The patient experienced noticeable pain reduction.
AFP Levels: The levels of alpha-fetoprotein, a marker for liver cancer, decreased.
Chest Wall Hernia: A previously unreported complication emerged.

Six months post-HIFU treatment, the patient developed a reducible mass on his right chest wall, diagnosed as a chest wall hernia. Despite this complication, which required no specific treatment as it didn't affect his quality of life, the patient survived for 44 months post-diagnosis, with his AFP levels decreasing to 182 ng/ml. This case underscores that HIFU is an effective treatment for those with unresectable HCC.

HIFU: Weighing the Benefits and Risks

HIFU offers a valuable alternative for patients with advanced HCC who are not candidates for surgery, TACE, RFA, or targeted drug therapies. While this case study highlights the potential for effective tumor control and improved survival, it also brings to light the importance of understanding and managing potential complications, such as chest wall hernia. As with any medical procedure, a thorough evaluation of the patient's condition and a careful consideration of the risks and benefits are essential in determining the most appropriate treatment strategy.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3892/ol.2016.4618, Alternate LINK

Title: Chest Wall Hernia Induced By High Intensity Focused Ultrasound Treatment Of Unresectable Massive Hepatocellular Carcinoma: A Case Report

Subject: Cancer Research

Journal: Oncology Letters

Publisher: Spandidos Publications

Authors: Qi-Wen Chen, Wen-Jing Teng, Qian Chen

Published: 2016-05-25

Everything You Need To Know

What is High-Intensity Focused Ultrasound (HIFU), and why is it used for liver cancer?

High-Intensity Focused Ultrasound (HIFU) is a minimally invasive, localized thermal ablation therapy. It precisely targets and destroys solid tumors by delivering focused ultrasound waves, generating heat within the tumor. This process promotes quicker recovery and enhances the body's immune response against the tumor. Its significance lies in providing a treatment option for individuals with advanced Hepatocellular Carcinoma (HCC) who aren't eligible for surgery or other treatments.

Why is High-Intensity Focused Ultrasound (HIFU) considered a valuable treatment option for liver cancer?

HIFU is considered a valuable treatment because it offers a non-invasive method to target and destroy tumors, especially in cases where surgery isn't an option. Its ability to precisely target tumors in three dimensions minimizes damage to surrounding tissues, promoting faster recovery. Also, its promotion of the body's own immune system to fight the tumor adds an advantage. Its significance is underscored by cases where it has demonstrated effective tumor control and improved survival rates, offering hope for patients with advanced Hepatocellular Carcinoma (HCC).

What is hepatocellular carcinoma (HCC), and why is it so important to consider alternative treatments?

Hepatocellular carcinoma (HCC) is a type of liver cancer that is among the most common and deadly cancers worldwide. HCC often gets diagnosed at a late stage when the liver function is significantly compromised, making surgical options impossible. This is important because the advanced stage limits treatment options. When surgery isn't possible, alternative treatments like TACE, RFA, and targeted drugs are considered, but these may not always be suitable based on the tumor's size or location.

What is alpha-fetoprotein (AFP), and why is it important to monitor its levels in liver cancer patients?

Alpha-fetoprotein (AFP) is a protein that is often elevated in patients with hepatocellular carcinoma (HCC). Monitoring AFP levels is crucial because it serves as a marker for liver cancer. A significant decrease in AFP levels following treatment, such as High-Intensity Focused Ultrasound (HIFU), can indicate a positive response to therapy and effective tumor control. Persistently high or increasing AFP levels may suggest treatment failure or disease progression. In the case study, the patient's AFP levels decreased substantially after HIFU treatment, which signifies its effectiveness.

What is a chest wall hernia, and why is it being discussed in the context of liver cancer treatment?

A chest wall hernia is a rare and unexpected complication that can potentially arise following High-Intensity Focused Ultrasound (HIFU) treatment for liver cancer. Although the exact mechanism is unclear, it may be related to the thermal effects of HIFU on the tissues of the chest wall. Although this case study showed the patient didn't require additional treatment it is important to consider all aspects of any medical procedure.