title: [Non-surgical treatment of hepatocellular carcinoma with tumor thrombus in the right atrium].
abstract: A 65-year-old Japanese man who had been suffering from severe and progressive dyspnea for more than 2 months underwent an extended right hepatectomy for hepatocellular carcinoma (HCC) in August 2001. Radiological examination, performed in August 2003, revealed the mass in the left lobe of the liver extended into the left hepatic vein, the inferior vena cava and the right atrium. Those clinical manifestations were supposedly attributed to HCC tumor thrombus in the right atrium. The decision to carry out the palliative operation for the tumor thrombus was not made because of poor prognosis in light of hemodynamic compromise indicating a reasonable liver function. A sequential course of treatments for the tumor thrombus was performed including transcatheter chemotherapy, transarterial chemoembolization and radiation therapy. Although a radiological response rate was 27% in diameter of the tumor thrombus, the clinical manifestations, such as dyspnea or edema, completely disappeared during the treatment. No surgical standard or interventional regimen for HCC tumor thrombus in the right atrium has been established. However, we here demonstrated the possibility for the treatment of the tumor thrombus with intensive combination therapies.
authors.affiliation: Dept. of Surgery, Hyogo Prefectural Nishinomia Hospital.
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Hayashi
authors.forename: Hasuike
authors.initials: H
authors.lastname: Yasunori
authors.forename: Itsuro
authors.initials: I
authors.lastname: Soma
authors.forename: Nariaki
authors.initials: N
authors.lastname: Fukuchi
authors.forename: Hikaru
authors.initials: H
authors.lastname: Izawa
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yoshida
authors.forename: Chikara
authors.initials: C
authors.lastname: Ebisui
authors.forename: Isao
authors.initials: I
authors.lastname: Sakita
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Koshino
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Izumiyama
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takeda
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Fujimoto
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D006325:Heart Atria; D006338:Heart Neoplasms / Q000532:radiotherapy / Q000628:therapy*; D006498:Hepatectomy; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*