Hepatocellular carcinoma with right atrial tumor thrombus: Report of a case

Inoué, Yoshihiro; Hayashi, Michihiro; Katsumata, Takahiro; Shibayama, Yuro; Tanigawa, Nobuhiko

doi:10.1007/s00595-010-4443-5

Cited by 32 publications

(36 citation statements)

References 8 publications

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“…Currently, surgical removal can prolong the life of the patient. Some scholars reported a case of the successful simultaneous resection of HCC and a tumor thrombus extending into the RA under cardiopulmonary bypass, after which the patient survived for more than 2 years . However, multiple metastases were found in both lungs in this case, and the patient presented with advanced liver cancer and had missed the opportunity for surgical treatment.…”

Section: Discussionmentioning

confidence: 85%

Hepatocellular carcinoma with inferior vena cava and right atrial tumor thrombus: A case report

2019

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This is a case report of a 45-year-old patient admitted with the symptom of bilateral leg swelling. Ultrasonography revealed a hyperechoic mass in the right lobe of the liver, which invaded the right hepatic vein (RHV) and extended into the inferior vena cava (IVC) and right atrium (RA). Based on the high alpha-fetoprotein (AFP) level and the ultrasonography findings, the patient was diagnosed as having hepatocellular carcinoma (HCC) with a RHV, IVC, and RA tumor thrombus and secondary Budd-Chiari syndrome (BCS). HCC with a tumor thrombus extending into the IVC and RA has rarely been observed, and as a cause of secondary BCS, this type of HCC has been even more rarely reported. K E Y W O R D S hepatocellular carcinoma, inferior vena cava, right atrium, tumor thrombus S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section. Movie S1. Transthoracic echocardiography, apical 4-chamber view, revealed a thrombus (yellow arrow) in the RA. RA = right atrium; RV = right ventricle; LA = left atrium; LV = left ventricle; TT = tumor thrombus; IVC = inferior vena cava. Movie S2. Transthoracic echocardiography showed the TT in the RA coming from the IVC and the thrombus in the RHV and IVC (red arrow). RA = right atrium; RV = right ventricle; TT = tumor thrombus; IVC = inferior vena cava; RHV = right hepatic vein. Movie S3. Abdominal ultrasound showed the TT coming from the IVC (red arrow) and integrating with the liver mass (white arrow). LV = left ventricle; RV = right ventricle; TT = tumor thrombus; IVC = inferior vena cava. Movie S4. Transthoracic echocardiography showed that the tumor thrombus in the RHV, IVC (red arrow) and RA was continuous. RA = right atrium; RV = right ventricle; TT = tumor thrombus; IVC = inferior vena cava; RHV = right hepatic vein. How to cite this article: Chen M, Huang X, Yang Q. Hepatocellular carcinoma with inferior vena cava and right atrial tumor thrombus: A case report. Echocardiography.

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Section: Discussionmentioning

confidence: 85%

Hepatocellular carcinoma with inferior vena cava and right atrial tumor thrombus: A case report

2019

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“…[11] There are few reports of en bloc hepatectomy and resection of the RA thrombus under cardiopulmonary bypass, with a median survival of 11 months. [12]…”

Section: Discussionmentioning

confidence: 99%

Mobile right atrial thrombus with pulmonary thromboembolism in a patient with advanced hepatocellular carcinoma and disseminated tumor thrombosis

et al. 2011

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We report a 61-year-old male patient who presented with one month history of exertional dyspnea, persistent dry cough, abdominal pain with distension, poor appetite, and weight loss. This case illustrates a rare presentation of hepatocellular carcinoma with mobile right atrial thrombus and pulmonary embolism along with disseminated tumor thrombosis at multiple sites. Furthermore, this case reiterates that an early detection and diagnosis may have increasing importance in the advent of new therapies for treating advanced hepatocellular carcinoma

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“…Hepatocellular carcinoma (HCC) is an aggressive malignancy with a potential to invade intrahepatic vasculature [1]. HCC with a tumor thrombus extending into the right atrium (RA) via the inferior vena cava (IVC) is rare, with a documented incidence of 1-4.8% in autopsy series [1,2], but it is increasingly reported clinically with the development of medical imaging techniques [3]. The advanced HCC can be managed by non-surgical treatments, such as conservative treatment, transarterial chemoembolization (TACE) and radiotherapy [4].…”

Section: Introductionmentioning

confidence: 99%

“…The maximal size of RA tumor thrombus was 4.6±2.3 (range, 2-15; median, 4.4) cm (n=42). RA tumor thrombus-induced tricuspid orifice occlusion of different degrees was noted in 3 patients [10, 15, 31].Simultaneous lung metastasis was found in 6 patients[2,8,10,17,37,47]. Diaphragm metastasis occurred in 1 patient[7].…”

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confidence: 99%

Hepatocellular carcinoma with right atrial tumor thrombus: a systematic review

Yuan

Guo²

2020

Preprint

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Background: Hepatocellular carcinoma with right atrial tumor thrombus is uncommon but with a dismal prognosis. Methods: By comprehensive retrieval of literature published between 2000 and 2019, 53 reports were obtained with 187 patients recruited into this study. The extracted data included patient characteristics, tumor characteristics, treatment, follow-up and outcomes. Statistical analyses applied were student t , Fisher exact and I 2 tests. Patients were devided into 6 groups according to treatment of choices: transarterial chemoembolization (TACE), surgery, radiotherapy, chemotherapy, interventional treatment and supportive care. Results: The overall survival rate of this cohort was 40.8%. The survival rate of patients receiving TACE was 33.3% and that of surgical patients was 41.9%. The survival time of patients with TACE was longer than surgical patients, but lack of a statistical significance. Patients had a follow-up of 15.7±16.6 (median 10) months. The patients receiving radiotherapy had the longest follow-up among all groups. Intra- and/or extrahepatic recurrence of hepatocellular carcinoma was the major mobidity. The mortality rates in a decremental sequence for patients receiving different treatments were supportive care >radiotherapy >surgery >TACE >interventional treatment. No difference was found in mortality between patients reported from case reports and those from non-case reports. Conclusions: Even though advanced hepatocellular carcinoma with right atrial thrombus is an aggressive malignancy, the the present study showed that patients’ prognosis was improved and survival time elongated with active treatments such as TACE and surgery. The present systematic review reveals improved outcomes with active treatments against conservative treatments.

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Hepatocellular carcinoma with right atrial tumor thrombus: Report of a case

Cited by 32 publications

References 8 publications

Hepatocellular carcinoma with inferior vena cava and right atrial tumor thrombus: A case report

Hepatocellular carcinoma with inferior vena cava and right atrial tumor thrombus: A case report

Mobile right atrial thrombus with pulmonary thromboembolism in a patient with advanced hepatocellular carcinoma and disseminated tumor thrombosis

Hepatocellular carcinoma with right atrial tumor thrombus: a systematic review

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