title: HCC with tumor thrombus entering the right atrium and inferior vena cava treated by percutaneous ablation.
abstract: BACKGROUND
  In the advanced stages of hepatocellular carcinoma (HCC), a tumor thrombus (TT) can form in the portal or hepatic vein. The management of patients with advanced HCC and a TT extending into the right atrium (RA) and inferior vena cava (IVC) is extremely difficult and risky.
  
  
  METHODS
  We report the case of a patient with HCC and a large TT (85 × 45 mm) extending into the RA through the hepatic vein and IVC, which is very rare. We performed percutaneous microwave ablation of the TT and the two intrahepatic tumors (maximum diameter, 57 mm). The treatment shrank the tumors, and the patient is in good condition and has survived for 16 months thus far. A literature review was also performed. This is the first such case to be treated with percutaneous microwave ablation.
  
  
  CONCLUSIONS
  The outcomes in this case suggest that percutaneous ablation is useful for the treatment of TT extending into the RA and IVC in patients with HCC.
authors.affiliation: Center of Interventional Oncology and Liver Diseases, Beijing You'an Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai St., Fengtai Dist., Beijing, 100069, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Center of Interventional Oncology and Liver Diseases, Beijing You'an Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai St., Fengtai Dist., Beijing, 100069, People's Republic of China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Center of Interventional Oncology and Liver Diseases, Beijing You'an Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai St., Fengtai Dist., Beijing, 100069, People's Republic of China.
authors.forename: Wenfeng
authors.initials: W
authors.lastname: Gao
authors.affiliation: Center of Interventional Oncology and Liver Diseases, Beijing You'an Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai St., Fengtai Dist., Beijing, 100069, People's Republic of China. zhengjiasheng6@sina.com.
authors.forename: Jiasheng
authors.initials: J
authors.lastname: Zheng
mesh_terms: D000368:Aged; D006502:Budd-Chiari Syndrome / Q000473:pathology / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008872:Microwaves; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000601:surgery
keywords: Ablation; Case report; Hepatocellular carcinoma; Percutaneous; Right atrium; Tumor thrombus