Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2021; 9(26): 7893-7900
Published online Sep 16, 2021. doi: 10.12998/wjcc.v9.i26.7893
Hepatocellular carcinoma with inferior vena cava and right atrium thrombus: A case report
Jin Liu, Ri-Xin Zhang, Bing Dong, Kun Guo, Zhen-Ming Gao, Li-Ming Wang
Jin Liu, Ri-Xin Zhang, Bing Dong, Zhen-Ming Gao, Li-Ming Wang, Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, Liaoning Province, China
Kun Guo, Department of Pathology, The Second Affiliated Hospital of Dalian Medical University, Dalian 116023, Liaoning Province, China
Author contributions: All authors participated in the management of the patient in this case report; Liu J and Wang LM developed the main concept and designed the study; Liu J drafted the manuscript; Gao ZM edited the manuscript; Zhang RX and Dong B did literature search and data collection; Guo K assisted with the pathology part of the manuscript; Wang LM supervised the whole process.
Supported by the National Natural Science Foundation of China, No. 81972749 and No. 81471755; and Education Department of Liaoning Province, No. XLYC1802011.
Informed consent statement: Written informed consent was obtained from the patient to have the case details and any accompanying images published.
Conflict-of-interest statement: The authors declare no conflicts of interests related to this manuscript.
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: Li-Ming Wang, MD, PhD, Chief Doctor, Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, No. 467 Zhongshan Road, Shahekou District, Dalian 116023, Liaoning Province, China. wangbcc259@163.com
Received: April 8, 2021
Peer-review started: April 8, 2021
First decision: June 4, 2021
Revised: June 5, 2021
Accepted: July 22, 2021
Article in press: July 22, 2021
Published online: September 16, 2021
Abstract
BACKGROUND

Hepatocellular carcinoma (HCC) with inferior vena cava and right atrium thrombus is rare, accounting for approximately 1.4%-4.9% of cases. These patients are rarely reported, but the condition is being increasingly discovered with advances in imaging techniques, and their prognosis is extremely pessimistic with no current effective treatment. This condition is further associated with unexpected sudden death by cardiac arrest and acute large area pulmonary embolism.

CASE SUMMARY

A 34-year-old man with advanced HCC with a hepatic vein thrombus extending into the right atrium had a long-term, disease-free survival following 5-mo sequential treatment combined with transcatheter arterial chemoembolization and curative liver resection. No severe adverse effects were encountered, such as massive hemorrhage or pulmonary embolism. The proper selection of operative method is an important factor.

CONCLUSION

HCC with a tumor thrombus extending into the right atrium has a significant impact on the survival of patients. Thrombectomy combined with adjuvant therapy may be beneficial for these patients.

Keywords: Cardiopulmonary bypass, Hepatic neoplasms, Hepatic vein tumor thrombus, Liver resection, Transcatheter arterial chemoembolization, Case report

Core Tip: Hepatocellular carcinoma with a tumor thrombus extending into the right atrium has a huge impact on the survival of the patients. It is further associated with unexpected sudden death by cardiac arrest and acute large area pulmonary embolism. Thrombectomy combined with adjuvant therapy may bring light for these patients.