Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Nov 27, 2020; 12(11): 1128-1135
Published online Nov 27, 2020. doi: 10.4254/wjh.v12.i11.1128
Hepatocellular carcinoma with tumor thrombus extends to the right atrium and portal vein: A case report
Diego Gomez-Puerto, Oriol Mirallas, Judit Vidal-González, Victor Vargas
Diego Gomez-Puerto, Oriol Mirallas, Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona 08035, Spain
Judit Vidal-González, Liver Unit, Hospital Vall d’Hebron, CIBERehd, Barcelona, Spain
Victor Vargas, Liver Unit, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, CIBERehd, Barcelona, Spain
Author contributions: Gomez-Puerto D collected all of the data, wrote the first article draft, and reviewed the final version; Mirallas O drafted and critically reviewed the article, summarized each section, and edited the images of the article; Vidal-González J drafted some sections of the manuscript, obtained informed consent, and critically reviewed the entire article; Vargas V provided the final approval, expertise, mentorship and final revision.
Informed consent statement: Consent was obtained from the patient, and the signed Informed Consent Form was provided to the publisher.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016) and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Oriol Mirallas, MD, Occupational Physician, Medical Oncology Department, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron, 119, Barcelona 08035, Spain. omirallas@vhebron.net
Received: July 12, 2020
Peer-review started: July 12, 2020
First decision: August 9, 2020
Revised: August 23, 2020
Accepted: September 15, 2020
Article in press: September 15, 2020
Published online: November 27, 2020
Processing time: 124 Days and 2.9 Hours
Core Tip

Core Tip: Hepatocellular carcinoma (HCC) with tumor thrombus (TT) in the right atrium (RA) is an unusual but critical condition. There is no standard treatment strategy or consensus. Alpha-fetoprotein is reportedly a new alternative biomarker to RECIST in order to detect tyrosine kinase inhibitors response in HCC, and our case supports this hypothesis. We report this HCC case due to the exceptionality of a TT extending into the RA in a patient with stable cirrhosis. We believe this case will warn professionals when facing similar cases, so systemic treatment can be started in a timely fashion and the treatment response can be evaluated with a serial blood test in patients suffering from advanced HCC.