title: Marked clinical improvement in patients with hepatocellular carcinoma by surgical removal of extended tumor mass in right atrium and pulmonary arteries.
abstract: Two patients with advanced hepatocellular carcinoma presented severe exertional dyspnea because of extension of a tumor into the right side of the heart. Removable of the tumor thrombus by open-heart surgery ameliorated the symptoms in each case, but their subsequent courses differed considerably. One patient survived for as long as 8 months thanks to successive multi-disciplinary treatments, whereas the other patient died suddenly 1 month after the surgery. The first patient's hepatocellular carcinoma was more differentiated, and the dyspnea was caused by a low cardiac output due to the intracardiac tumor mass, not by pulmonary embolism as in the second patient's case. We conclude that successive multidisciplinary treatments to control the growth of hepatocellular carcinoma is the most important approach and is indispensable for improving the prognosis.
authors.affiliation: Division of Gastroenterology, National Medical Center, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Masaki
authors.forename: S
authors.initials: S
authors.lastname: Hayashi
authors.forename: T
authors.initials: T
authors.lastname: Maruyama
authors.forename: H
authors.initials: H
authors.lastname: Okabe
authors.forename: M
authors.initials: M
authors.lastname: Matsukawa
authors.forename: J
authors.initials: J
authors.lastname: Unno
authors.forename: S
authors.initials: S
authors.lastname: Maekawa
authors.forename: T
authors.initials: T
authors.lastname: Oka
authors.forename: M
authors.initials: M
authors.lastname: Tani
authors.forename: K
authors.initials: K
authors.lastname: Matsueda
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D006325:Heart Atria / Q000601:surgery*; D006338:Heart Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011379:Prognosis; D011651:Pulmonary Artery; D013927:Thrombosis / Q000209:etiology / Q000601:surgery*