title: [A long-term survival case of hepatocellular carcinoma with bone metastasis and inferior vena cava tumor thrombus successfully treated with multidisciplinary therapy].
abstract: A 54-year-old man was diagnosed as hepatitis B in 1987 and observed. In January 2007, he was detected a 7 cm mass in the posterior segment of the liver with inferior vena cava tumor thrombus (Vv3), a 4.5 cm mass and multiple small nodules in the liver by computed tomography. Moreover, his right pubic bone has solitary small osteolytic change in x-ray and abnormal up take on bone scintigram. We diagnosed it having a highly advanced hepatocellular carcinoma (HCC) with bone metastasis. We started to treat with multidisciplinary therapy. We performed Transarterial chemoembolization (TACE) twice for intrahepatic lesions and radiotherapy for bone metastasis. Interferon-α and S-1 combination therapy were performed for three months. A new lesion in the liver was appeared advanced slowly 16 months after the last TACE, and caused to increase PIVKA-II. He received TACE for this lesion. Three years after the diagnosis, and he is alive in good condition without a new extrahepatic metastasis. This case suggests that some patients with highly progressive HCC involving inferior vena cava tumor thrombus (Vv3) and bone metastasis can gain a long-term survival by multidisciplinary therapy including TACE and Interferon-α and S-1.
authors.affiliation: Dept. of Surgery, Graduate School of Medicine, Osaka University.
authors.forename: Daisaku
authors.initials: D
authors.lastname: Yamada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.forename: Shogo
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Marubashi
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Eguchi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takeda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tanemura
authors.forename: Koji
authors.initials: K
authors.lastname: Umeshita
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000556:secondary*; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D004338:Drug Combinations; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D016898:Interferon-alpha / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D010094:Oxonic Acid / Q000627:therapeutic use; D005641:Tegafur / Q000627:therapeutic use; D014682:Vena Cava, Inferior; D020246:Venous Thrombosis
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; D007155:Immunologic Factors; D016898:Interferon-alpha; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid