title: Hepatocellular Carcinoma With Tumor Thrombus Occupying the Right Atrium and Portal Vein: A Case Report and Literature Review.
abstract: Hepatocellular carcinoma (HCC) patients with tumor thrombus extended through the major hepatic veins and inferior vena cava into the right atrium (RA) are rare, and most cases are considered as the advanced stage with a poor prognosis.We report a case of HCC with a tumor thrombus extending into the RA and a tumor thrombus in the portal vein. A literature search for case reports was performed on PubMed.Compared with the published literature, our case is one of the youngest patients, but with the most advanced HCC that invades both the hepatic inflow and outflow vasculature. For this patient, we resected the tumor thrombus in the RA with the use of cardiopulmonary bypass, and then removed the tumor thrombus in the portal vein and ligated the left branch of portal vein. Because of insufficient remnant liver volume, microwave ablation and transcatheter arterial chemoembolization were performed to control the growth of HCC. The patient survived 6 months after surgery.This case suggests that for patients with extension of HCC into the RA and portal vein, surgery is a useful therapeutic modality, even in case that liver tumor cannot be resected.
authors: From the Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors: Xin
authors: X
authors: Luo
authors: Binhao
authors: B
authors: Zhang
authors: Shuilin
authors: S
authors: Dong
authors: Bixiang
authors: B
authors: Zhang
authors: Xiaoping
authors: X
authors: Chen
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D002315:Cardiopulmonary Bypass / Q000379:methods; D002353:Carrier State; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D018450:Disease Progression; D017128:Embolectomy / Q000379:methods*; D017809:Fatal Outcome; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000601:surgery; D006509:Hepatitis B / Q000175:diagnosis; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000601:surgery; D019233:Retreatment / Q000379:methods; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000601:surgery