How would you treat a hepatic dome HCC lesion in a patient with a history of ILD?

This depends on the other treatment options available to the patient. If technically feasible, one might favor either radiofrequency ablation (if accessible, though perhaps complicated in the dome) or TACE (transarterial chemoembolization), provided there is not significant blood supply from the phrenic circulation. Surveillance might also be considered if the patient is medically unstable or has expected survival <1 year, particularly if the HCC is small and slow-growing.

The risks of y-90 in pa...