Please use this identifier to cite or link to this item:
10.1159/000529831
Title: | Surgical Treatment of Hepatocellular Carcinoma with a Tumor Thrombus Invading the Right Atrium : A Case Report |
Authors: | Veinberga, Laura Meidrops, Kristians Rumba, Roberts Gedins, Marcis Anufrijevs, Deniss Vilmanis, Janis Drizlionoka, Karina Zellans, Edgars Krustina, Inguna Berzins, Juris Briede, Inese Sivins, Armands Radzina, Maija Stradins, Peteris Ozolins, Arturs Department of Surgery Department of Pathology Department of Radiology |
Keywords: | Hepatocellular carcinoma;Tumor thrombus;Right atrium;Liver resection;Cavo-atrial thrombectomy;3.2 Clinical medicine;1.1. Scientific article indexed in Web of Science and/or Scopus database |
Issue Date: | 8-Jun-2023 |
Citation: | Veinberga , L , Meidrops , K , Rumba , R , Gedins , M , Anufrijevs , D , Vilmanis , J , Drizlionoka , K , Zellans , E , Krustina , I , Berzins , J , Briede , I , Sivins , A , Radzina , M , Stradins , P & Ozolins , A 2023 , ' Surgical Treatment of Hepatocellular Carcinoma with a Tumor Thrombus Invading the Right Atrium : A Case Report ' , Case Reports in Oncology , vol. 16 , no. 1 , pp. 437-445 . https://doi.org/10.1159/000529831 |
Abstract: | Up to 3% of all hepatocellular carcinomas (HCCs) present with a tumor thrombus (TT) in the inferior vena cava (IVC) and right atrium (RA). Extensive growth of HCC into the IVC and the RA is associated with a particularly poor prognosis. This clinical condition is related to a high risk of sudden death due to pulmonary embolism or acute heart failure. Therefore, a technically challenging treatment undergoing hepatectomy and cavo-atrial thrombectomy is necessary. We report a 61-year-old man presenting with right subcostal pain, progressive weakness, and periodic shortness of breath for 3 months. He was diagnosed with advanced HCC with a TT extending from the right hepatic vein into the IVC and RA. A multidisciplinary meeting with cardiovascular and hepatobiliary surgeons, oncologists, cardiologists, anesthesiologists, and radiologists was held to determine the best treatment approach. Initially, the patient underwent right hemihepatectomy. As follows, the cardiovascular stage using cardiopulmonary bypass was successfully performed, removing the TT from the RA and ICV. In the early postoperative period, the patient remained stable and was discharged on the 8th postoperative day. A morphological examination revealed grade 2/3 HCC, a clear cell variant with microvascular and macrovascular invasion. Immunohistochemical staining was positive for HEP-1, CD10, whereas negative for S100. The morphological and immunohistochemical results corresponded to HCC. The treatment of such patients requires the cooperation of various specialties. Although the approach of the surgery is extremely complex including specific technical support, as well as high perioperative risks, the result offers favorable clinical outcomes. |
Description: | Publisher Copyright: © 2023 S. Karger AG. All rights reserved. |
DOI: | 10.1159/000529831 |
ISSN: | 1662-6575 |
Appears in Collections: | Research outputs from Pure / Zinātniskās darbības rezultāti no ZDIS Pure |
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Surgical_Treatment_of_Hepatocellular.pdf | 1.32 MB | Adobe PDF | View/Open |
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