title: Tumor thrombi in the portal vein system originating from gastrointestinal tract cancer.
abstract: Intraluminal tumor thrombus in the portal vein (PV) system originating from gastrointestinal (GI) tract cancer is a rare condition. There are two types of such thrombi, one arising indirectly from metastatic liver cancer and the other directly from the primary lesion. We report here three patients with the direct type and two with the indirect type; i.e., a total of five patients with gastric or large intestinal cancer with PV tumor thrombus. In all patients, the primary lesion was surgically resected; in two patients, the tumor thrombus was easily extirpated by direct opening of the PV. It is noteworthy that a patient whose tumor thrombus could not be treated died of cancer with liver failure, caused by expansive growth of the PV tumor thrombus, 4 months after the finding of the PV thrombus. Because PV tumor thrombus may, possibly, determine the patient's length of survival, in addition to causing cancer progression, surgical thrombectomy, combined with resection of the primary cancer and metastatic liver cancer, should be considered for prolongation of survival, if all macroscopic lesions can be controlled and if the tumor thrombus is a synchronous and recent one.
authors.affiliation: Department of Emergency Medicine, Kyoto University Hospital, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Tanaka
authors.forename: Ryoji
authors.initials: R
authors.lastname: Takeda
authors.forename: Sumio
authors.initials: S
authors.lastname: Mukaihara
authors.forename: Katsumi
authors.initials: K
authors.lastname: Hayakawa
authors.forename: Koushou
authors.initials: K
authors.lastname: Takasu
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Terajima
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yamaoka
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Chiba
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D011169:Portal Vein / Q000601:surgery; D011859:Radiography; D013274:Stomach Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*