Long-term survival after chemoembolization of metastatic right atrial tumor thrombus as a presenting feature of hepatocellular carcinoma: A case study

Sun, Junhui; Zhang, Yuelin; Nie, Chun‐Hui; Chen, Liming; He, Jiandi; Wang, Weilin; Zheng, Shusen

doi:10.3892/ol.2012.618

Cited by 9 publications

(8 citation statements)

References 16 publications

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“…Surgical thrombectomy is the main therapeutically option but, radiofrequency ablation, chemoembolization, thalidomide, and sorafenib have also been described as feasible alternatives for advanced hepatocellular carcinoma, despite the high mortality rate within a couple of months whether the patient is treated or not 19 , 26 , 28…”

Section: Discussionmentioning

confidence: 99%

Progressive dyspnea and a right atrial mass in an 80-year-old man

et al. 2019

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Hepatocellular carcinoma (HCC) is among the five most frequent causes of cancer death worldwide, according to the WHO. The disease is related to alcohol abuse, viral infections, and other causes of cirrhosis, and unfortunately, in some developed countries, the incidence shows an increasing trend. Although the diagnosis of the HCC often relies upon the context of a chronic hepatopathy, some cases may present a silent course, and the initial symptoms ensue when the disease is in an advanced stage with no chance for any therapeutic attempt. The clinical picture of the HCC is varied, and unexpected forms may surprise the clinician. One of the unusual presentations of the HCC is shock by the blockage of the venous return to the right atrium by the inferior vena cava infiltration. Herein we present a case of an old patient who sought medical care complaining of dyspnea. The clinical workup disclosed a right thorax pleural effusion and imaging exams depicted a mass in the right hepatic lobe, invasion of the inferior vena cava (IVC) and the right atrium (RA). During the attempts of clinical investigation, the patient passed away. The autopsy disclosed an HCC involving the right hepatic lobe, with the invasion of the IVC and the RA. The authors highlight the importance of recognizing the bizarre presentation of not so rare diseases.

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Section: Discussionmentioning

confidence: 99%

Progressive dyspnea and a right atrial mass in an 80-year-old man

et al. 2019

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“…Such TTs are usually found in imaging studies. Complete obstruction of the HV and IVC may cause Budd-Chiari syndrome ( 10 ). The patient can present with manifestations such as varicose veins of the esophagus, fundus, upper extremity in relation to varicose veins of bilateral upper limbs, thoracic cavity and abdomen, pleural effusion, lower extremity edema, tachycardia and difficulty breathing, syncope, repeated pneumonia and sudden death ( 6 , 11 ).…”

Section: Clinical Manifestations Of Tt In Ivc/ramentioning

confidence: 99%

Diagnosis, treatment and prognosis of hepatocellular carcinoma with inferior vena cava/right atrium tumor thrombus (Review)

Xia

Zhang

2020

Oncol Lett

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Although tumor thrombus (TT) infringement of the inferior vena cava (IVC) and right atrium (RA) is rarely observed in hepatocellular carcinoma (HCC), the prognosis for this condition is extremely poor, with a median survival time of several months, given that the condition is often diagnosed at an advanced tumor stage or combined with multiple systemic metastases. Furthermore, there is no established effective treatment for the condition. However, some investigators insist that active treatment, including surgery, chemotherapy (systemic or intra-arterial), radiation therapy, best supportive care or a combination of these, may help prolong overall survival time in these patients. The management of patients with advanced HCC and a TT extending into the RA and IVC is extremely difficult and risky. To this end, the present review assessed the literature on the clinical features and treatments of this condition in recent years, with the aim of providing assistance for clinical work.

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“…Complete/partial regression of liver and RA tumor, α-fetoprotein decrease, and symptom-free were observed at 1-4 months [1]. Selective embolization with pirarubicin 30 mg, oxaliplatin 200 mg, hydroxycamptothecine 20 mg, and iodized-oil was also reported, obtaining similar effects to thalidomide [46].…”

Section: Treatmentmentioning

confidence: 99%

Hepatocellular carcinoma with right atrial tumor thrombus

Guo

2020

Z Gastroenterol

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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 I2 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 morbidity. 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 Advanced hepatocellular carcinoma with right atrial thrombus is an aggressive malignancy. Based on the results of median survival time, radiotherapy and TACE seemed to be associated with an improved prognosis and possible better survival.

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Long-term survival after chemoembolization of metastatic right atrial tumor thrombus as a presenting feature of hepatocellular carcinoma: A case study

Cited by 9 publications

References 16 publications

Progressive dyspnea and a right atrial mass in an 80-year-old man

Progressive dyspnea and a right atrial mass in an 80-year-old man

Diagnosis, treatment and prognosis of hepatocellular carcinoma with inferior vena cava/right atrium tumor thrombus (Review)

Hepatocellular carcinoma with right atrial tumor thrombus

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