Hypothyroidism in patients with hepatocellular carcinoma treated by transarterial chemoembolization

Introduction: Transarterial chemoembolization (TACE) is the standard of care for patients with an intermediate or advanced stage of hepatocellular carcinoma (HCC) and compensated liver cirrhosis. The procedure involves the application of approx. 10g of iodide in the form of iodized oil as radiopaque contrast medium, e.g. lipiodol, mixed with a chemotherapeutic agent. While contrast medium induced hyperthyroidism is well known, the development of hypothyroidism is generally not considered in clinical practice. This phenomenon is called Wolff Chaikoff effect and is caused by iodide induced inhibition of thyroid ho…