[Massive venous thrombosis with cardiac invasion as primary manifestation of hepatocarcinoma].
Hepatocellular carcinoma has a tendency to invade vascular structures. However, extension into the hepatic veins or heart is uncommon. We describe the case of a 68 years old man with chronic viral hepatitis type C, consulting about edema and pain in his left leg. Doppler scan showed deep venous thrombosis in that level and computed tomography of thorax and abdomen showed complete thrombosis of the inferior cava vein, thrombosis of the left suprahepatic vein, a voluminous thrombus in the right atrium and an irregular mass in the liver. Alpha-fetoprotein was 77,046 ng/ml The biopsy of the rigth atrium thrombus demonstrated diseminated hepatocellular carcinoma. We comment the patient progress after surgery, the incidence, clinical symptoms, and therapy options for these patients.
Servicio de Medicina Interna-Infecciosas. Universidad de Vigo. Vigo, Pontevedra. Spain. tumismo@grupobbva.net
M
M
Carnero Fernández
L E
LE
Morano Amado
P
P
Bodenlle Bello
F
F
Calvo Iglesias
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis* / Q000556:secondary; D006325:Heart Atria; D006338:Heart Neoplasms / Q000175:diagnosis / Q000556:secondary*; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D009361:Neoplasm Invasiveness; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology*; D014682:Vena Cava, Inferior; D020246:Venous Thrombosis / Q000209:etiology