title: Budd-Chiari syndrome as an initial presentation of hepatocellular carcinoma: a case report.
abstract: We report the case of a 84-year-old admitted with symptoms of congestive heart failure. Ultrasonography revealed a hyperechoic nodule in the left lobe of the liver, with a peripheral hypoechoic rim, multiple irregular hypoechoic nodules in both hepatic lobes, portal vein, inferior vena cava, and right atrium thrombosis. On ultrasonographic and alpha-fetoprotein criteria the case was interpreted as hepatocellular carcinoma with Budd-Chiari syndrome. The particularity of the case is the initial presentation of the hepatocellular carcinoma as Budd-Chiari syndrome. The inferior vena cava and right atrium thrombosis, as a cause of secondary Budd-Chiari syndrome in a patient with hepatocellular carcinoma, has been rarely reported.
authors.affiliation: Internal Medicine Department, "Sf. Ioan" Clinical Emergency Hospital,Bucharest, Romania. alicebalaceanu@yahoo.com.
authors.forename: Lavinia Alice
authors.initials: LA
authors.lastname: Bălăceanu
authors.affiliation: Internal Medicine Department, Clinical Emergency Hospital Bucharest, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Camelia Cristina
authors.initials: CC
authors.lastname: Diaconu
authors.affiliation: Internal Medicine Department, "Sf. Ioan" Clinical Emergency Hospital,Bucharest, Romania.
authors.forename: Gheorghiţa
authors.initials: G
authors.lastname: Aron
mesh_terms: D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D006502:Budd-Chiari Syndrome / Q000000981:diagnostic imaging*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D004452:Echocardiography; D006325:Heart Atria / Q000000981:diagnostic imaging; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D010166:Palliative Care; D013927:Thrombosis / Q000000981:diagnostic imaging; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins