Neovasculature of benign thrombus of the inferior vena cava demonstrated by computed tomography during hepatic arteriography, mimicking a small hepatocellular carcinoma.
A 64-year-old man who underwent hepatectomy for hepatocellular carcinoma (HCC) 4 years ago followed by transarterial chemoembolization for recurrent foci 1 year later had a thrombus in the inferior vena cava (IVC). Tumor thrombus derived from HCC was suspected owing to the increase in size and hepatic arteriography was performed. Common hepatic arteriography demonstrated a small stain suggesting a recurrent HCC in the remnant liver. However, CT during hepatic arteriography revealed that the stain localized not in the liver but within the thrombus in the IVC; there was no recurrent HCC in the liver. The dense stain associated with thin neovasculature developed through the thrombus was recognized. The thrombus spontaneously regressed 8 months later. It was speculated that the neovasculature played an important role in a process of absorption of the thrombus. One should note that the stain shown on angiography does not always suggest that the lesion is localized in the liver and is malignant.
Takayasu
Kenichi
K
Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan. ktakayas@ncc.go.jp
Mizuguchi
Yasunori
Y
Muramatsu
Yukio
Y
Shimada
Kazuaki
K
Takayama
Tadatoshi
T
Sato
Chise
C
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000601:surgery; D003937:Diagnosis, Differential; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior; D020246:Venous Thrombosis / Q000000981:diagnostic imaging*