Abstract
Primary hepatocellular carcinoma (HCC) is a prevalent malignancy in China, often diagnosed at intermediate to advanced stages, limiting the feasibility of curative surgical resection. Yttrium-90 selective internal radiation therapy ((90)Y-SIRT) has emerged as a novel treatment demonstrating potential for prolonging survival and inducing clinical remission in HCC patients. Its efficacy and safety have been progressively validated in clinical settings. This report describes a middle-aged male patient diagnosed with HCC accompanied by portal vein tumor thrombus. The treatment regimen comprised oral lenvatinib, intravenous sintilimab, and (90)Y-SIRT. Successful sequential surgery was performed 7 months after (90)Y-SIRT, and a 6-week follow-up showed no significant abnormalities. This case suggests that (90)Y-SIRT, combined with other therapies, may be effective for patients with intermediate to advanced stage HCC.