Hepatocellular Carcinoma With Tumor Thrombus Occupying the Right Atrium and Portal Vein

Luo, Xin; Zhang, Binhao; Dong, Shijun; Zhang, Bixiang; Chen, Xiaoping

doi:10.1097/md.0000000000001049

Cited by 34 publications

(39 citation statements)

References 29 publications

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“…Tumor extensions through vascular pathways are uncommon phenomena [1]. Hepatocellular carcinoma patients with tumor extended into the right atrium (RA) are rare, and very few have been reported [2]. We report here a rare event of transvascular growth of hepatocellular carcinoma.…”

Section: Introductionmentioning

confidence: 88%

Transvascular Growth of Hepatocellular Carcinoma

Ar¹,

Biji²,

Os³

et al. 2017

JCR

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Background: Cardiac tumors may be primary (benign or malignant) or metastatic (malignant). They can cause inflow-outflow tract obstruction, thromboembolism, arrhythmias, or pericardial disorders. Case Report: A 30 year old male presented with cough and dyspnea of one month duration. Routine echocardiography revealed a large tumor mass filling the entire right atrium. Computed tomography delineated tumor arising from the left lobe of the liver and entering through the inferior vena cava (IVC) to right atrium. Ultrasound guided biopsy demonstrated hepatocellular carcinoma. The patient initially improved with oral sorafenib (receptor tyrosine kinase inhibitor) and then succumbed to his primary illness after six months. Conclusion: We report here transvascular growth of hepatocellular carcinoma through IVC to right atrium, a rare phenomenon.

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Section: Introductionmentioning

confidence: 88%

Transvascular Growth of Hepatocellular Carcinoma

Ar¹,

Biji²,

Os³

et al. 2017

JCR

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“…Liver tumor was resected while RA tumor thrombi was not resected but treated with subsequent chemotherapy with bevacizumab in 1 patient [48], and RA and IVC tumor thrombi were removed while liver tumor was not resected but treated by microwave ablation/TACE in 2 patients [26,16].…”

Section: Treatmentmentioning

confidence: 99%

Hepatocellular carcinoma with right atrial tumor thrombus: a systematic review

Yuan

Guo²

2020

Preprint

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Background: Hepatocellular carcinoma with right atrial tumor thrombus is uncommon but with a dismal prognosis. Methods: By comprehensive retrieval of literature published between 2000 and 2019, 53 reports were obtained with 187 patients recruited into this study. The extracted data included patient characteristics, tumor characteristics, treatment, follow-up and outcomes. Statistical analyses applied were student t , Fisher exact and I 2 tests. Patients were devided into 6 groups according to treatment of choices: transarterial chemoembolization (TACE), surgery, radiotherapy, chemotherapy, interventional treatment and supportive care. Results: The overall survival rate of this cohort was 40.8%. The survival rate of patients receiving TACE was 33.3% and that of surgical patients was 41.9%. The survival time of patients with TACE was longer than surgical patients, but lack of a statistical significance. Patients had a follow-up of 15.7±16.6 (median 10) months. The patients receiving radiotherapy had the longest follow-up among all groups. Intra- and/or extrahepatic recurrence of hepatocellular carcinoma was the major mobidity. The mortality rates in a decremental sequence for patients receiving different treatments were supportive care >radiotherapy >surgery >TACE >interventional treatment. No difference was found in mortality between patients reported from case reports and those from non-case reports. Conclusions: Even though advanced hepatocellular carcinoma with right atrial thrombus is an aggressive malignancy, the the present study showed that patients’ prognosis was improved and survival time elongated with active treatments such as TACE and surgery. The present systematic review reveals improved outcomes with active treatments against conservative treatments.

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“…1 Although HCC has a tendency to spread into the venous system, intracardiac involvement is extremely rare and has a very poor prognosis. 2 Metastasis to the heart can occur via the blood stream, the lymphatic system or direct invasion through the IVC to the right atrium, with the latter occurring in 6.5-44% of HCC patients. 3,4 Such patients often exhibit symptoms of heart failure due to flow obstruction or a thromboembolism.…”

Section: Commentmentioning

confidence: 99%