Hepatocellular carcinoma with tumor thrombus extends to the right atrium and portal vein : a case report
Gomez-Puerto, Diego (Hospital Universitari Vall d'Hebron)
Mirallas, Oriol (Hospital Universitari Vall d'Hebron)
Vidal-González, Judit (Hospital Universitari Vall d'Hebron)
Vargas Blasco, Víctor (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Fecha:	2020
Resumen:	Hepatocellular carcinoma (HCC) is the most important primary malignant liver disease. A large proportion of patients with advanced HCC have macrovascular invasion. HCC tends to infiltrate vascular structures, particularly the portal vein and its branches, and more rarely, the hepatic veins. The intravascular tumor thrombus can affect the inferior vena cava (IVC) or even the right atrium (RA), the latter having a poor prognosis. HCC is one of the most aggressive malignant tumors. Tumor thrombus (TT) formation in advanced HCC stages is common and usually involves the hepatic or portal veins. Herein, we report a 69-year-old woman who presented with dyspnea to the emergency department. A ventilation/perfusion lung scan was performed, ruling out pulmonary embolism. Hepatopulmonary syndrome and portopulmonary hypertension were discarded with contrasted echocardiography, but a mass in the RA was detected and confirmed by cardiac magnetic resonance imaging. Abdominal computed tomography showed a liver mass with a dynamic enhancement pattern compatible with HCC and an intraluminal IVC mass extending from the hepatic vein into the RA. HCC with TT expansion to IVC and RA is rare and indicates poor prognosis. HCC with TT expansion to IVC and RA is rare and indicates poor prognosis. There is no consensus about anticoagulation or other interventions in these patients.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Hepatocellular carcinoma ; Alpha-fetoprotein ; Tumor thrombus ; Right atrium ; Sorafenib ; Case report
Publicado en:	World Journal of Hepatology, Vol. 12 (november 2020) , p. 1128-1135, ISSN 1948-5182

DOI: 10.4254/wjh.v12.i11.1128
PMID: 33312435

9 p, 3.9 MB

El registro aparece en las colecciones:
Artículos > Artículos de investigación
Artículos > Artículos publicados