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

Figure 1 Preoperative imaging examination. A: A medium echo was seen in the right atrium, with a clear boundary, local calcification on the surface, and wide base; B: Magnetic resonance imaging showed that there were filling defects in the hepatic vein and right atrium. IVC: Inferior vena cava; RA: Right atrium.

Figure 2 Images of surgical operation. A: Image of head of the tumor thrombus; B: Monitored image of transesophageal echocardiography during the operation; C: The hepatic vascular exclusion was blocked for 16 min; D: The entrance of the inferior vena cava and the right atrium was clear.

Figure 3 The shape and pathology of the tumor thrombus. A: The tumor is about 10 cm × 8.5 cm × 8 cm, and most of the mass is necrotic; B: Active cancer cells could be seen as finger-like bulge around the focal capsule, and necrosis area was over 75% (magnification 200 ×); C: The atrium thrombus is 15 cm × 5 cm × 3 cm with a long, thin neck.

Figure 4  There was no tumor recurrence or metastasis over a 2-year follow-up.