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HCC with tumor thrombus entering the right atrium and inferior vena cava treated by percutaneous ablation
Wei Li1, Yang Wang1, Wenfeng Gao1
1Center of Interventional Oncology and Liver Diseases, Beijing You'an Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai St., Fengtai Dist., Beijing, 100069, People's Republic of China.
Insights
Percutaneous microwave ablation offers a novel treatment for advanced hepatocellular carcinoma (HCC) with tumor thrombus (TT) extending into the right atrium and inferior vena cava. This minimally invasive approach demonstrated positive outcomes in a rare case, suggesting its potential utility.
Area of Science:
- Hepatobiliary surgery
- Interventional radiology
- Oncology
Background:
- Advanced hepatocellular carcinoma (HCC) can develop tumor thrombus (TT) in major vessels.
- TT extending into the right atrium (RA) and inferior vena cava (IVC) presents significant management challenges and risks.
Observation:
- A rare case of HCC with a large TT (85 × 45 mm) extending into the RA via the hepatic vein and IVC was encountered.
- The patient underwent percutaneous microwave ablation for the TT and intrahepatic tumors.
Findings:
- The percutaneous microwave ablation successfully reduced the size of the TT and intrahepatic tumors.
- The patient maintained good condition and survived for 16 months post-treatment.
- This represents the first reported instance of percutaneous microwave ablation for this specific condition.
Implications:
- Percutaneous ablation may be a viable and effective treatment option for HCC with extensive TT into the RA and IVC.
- This minimally invasive technique offers a potentially less risky alternative for managing complex HCC cases.
- Further research and case studies are warranted to validate the long-term efficacy of this approach.
Background:
In the advanced stages of hepatocellular carcinoma (HCC), a tumor thrombus (TT) can form in the portal or hepatic vein. The management of patients with advanced HCC and a TT extending into the right atrium (RA) and inferior vena cava (IVC) is extremely difficult and risky.
Case Presentation:
We report the case of a patient with HCC and a large TT (85 × 45 mm) extending into the RA through the hepatic vein and IVC, which is very rare. We performed percutaneous microwave ablation of the TT and the two intrahepatic tumors (maximum diameter, 57 mm). The treatment shrank the tumors, and the patient is in good condition and has survived for 16 months thus far. A literature review was also performed. This is the first such case to be treated with percutaneous microwave ablation.
Conclusion:
The outcomes in this case suggest that percutaneous ablation is useful for the treatment of TT extending into the RA and IVC in patients with HCC.
