Thoracoscopic Radiofrequency Ablation Therapy for Hepatocellular Carcinoma Above the Diaphragm Associated with Intractable Hemothorax

Ishikawa, Tomomasa; Kohno, Tamami; Teratani, Takuma; Omata, Masao

doi:10.1055/s-2002-34268

Cited by 4 publications

(6 citation statements)

References 2 publications

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“…The feeding arteries for ruptured thoracic HCC metastasis were identified as the intercostal artery ( 11 , 13 ), superficial cervical artery ( 15 ), inferior phrenic artery ( 21 ), and bronchial artery ( 24 ), whereas the inferior phrenic artery ( 18 ) as well as hepatic arteries ( 23 , 27 ) supplied the primary tumors responsible for hemothorax. Transcatheter treatment in this situation was found to be effective in achieving hemostasis in all cases except one ( 11 , 13 , 15 , 18 , 20 , 21 , 23 , 24 , 27 ). In our patient, we used a gelatin sponge and microcoils as embolic agents based on the CT findings indicating active bleeding from the chest wall metastasis of HCC, although extravasation was not evident on angiography.…”

Section: Discussionmentioning

confidence: 84%

“…Whereas our patient recovered from hemothorax without chest tube insertion, the majority of previous cases received chest drainage probably because of massive hemothorax ( 14 - 24 ). However, it is notable that initial conservative management only with chest drainage failed in some cases, as illustrated by repeated thoracentesis ( 18 - 20 ) or continuous bloody drainage from the chest tube ( 21 ). These findings suggest the palliative role of chest drainage and the importance of hemostatic procedures in the treatment for hemothorax resulting from ruptured HCC.…”

Section: Discussionmentioning

confidence: 99%

“…Although a rapidly deteriorating general condition can preclude therapeutic intervention ( 16 , 25 , 26 ), transcatheter procedures have been the most common treatment for HCC with hemothorax and they were applied in 10 cases ( Table ) ( 11 , 13 , 15 , 18 , 20 , 21 , 23 , 24 , 27 ). The feeding arteries for ruptured thoracic HCC metastasis were identified as the intercostal artery ( 11 , 13 ), superficial cervical artery ( 15 ), inferior phrenic artery ( 21 ), and bronchial artery ( 24 ), whereas the inferior phrenic artery ( 18 ) as well as hepatic arteries ( 23 , 27 ) supplied the primary tumors responsible for hemothorax.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Successful Transcatheter Arterial Embolization for Hemothorax from a Spontaneous Rupture of Hepatocellular Carcinoma Metastasis to the Chest Wall in an Elderly Patient

et al. 2021

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An 87-year-old man with hepatocellular carcinoma (HCC) presented with right-sided chest pain. Computed tomography revealed right bloody pleural effusion and an extravasation from an arterially enhanced mass in the right seventh posterior intercostal space. These findings indicated hemothorax from a rupture of HCC metastasis to the chest wall. Angiography of the intercostal arteries confirmed a hypervascular tumor, and transcatheter arterial embolization resulted in hemostasis. He was discharged with palliative care and remains alive after 9 months. Although hemothorax represents an unusual, life-threatening complication of HCC, our case suggests that transcatheter treatment can achieve hemostasis and a favorable survival even in elderly patients.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Successful Transcatheter Arterial Embolization for Hemothorax from a Spontaneous Rupture of Hepatocellular Carcinoma Metastasis to the Chest Wall in an Elderly Patient

et al. 2021

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“…According to our search, only 16 cases of ruptured HCC complicated by hemothorax have been reported in the literature [5-19], and the details of a total of 17 cases, including our case, are summarized in Table 1. Among them, four of the reported cases had ruptured primary HCC with direct invasion into the right pleural cavity [5-7,16], while others had ruptured metastatic HCC in the thorax [8-19] as the causes of hemothorax. However, no reports were found for cases of ruptured HCC in which blood flowed into the pleural cavity secondary to hemoperitoneum.…”

Section: Discussionmentioning

confidence: 99%

Hemothorax caused by spontaneous rupture of hepatocellular carcinoma: a case report and review of the literature

Ono¹,

Hiraga²,

Omura³

et al. 2012

World J Surg Onc

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We report a rare case in which hemothorax occurred in addition to hemoperitoneum due to spontaneous rupture of hepatocellular carcinoma (HCC) originating from the caudate lobe of the liver. The case pertains to a 56-year-old female who was transported to our hospital for impaired consciousness due to hemorrhagic shock. Computed tomography (CT) demonstrated ruptured HCC originating from the caudate lobe and accompanying hemoperitoneum and right hemothorax. Hemostasis was carried out by transcatheter arterial embolization (TAE), and surgery was conducted approximately one month after TAE. In the present case, no lesions as possible sources of bleeding were observed inside the pleural cavity, and, moreover, the diaphragm had no abnormalities in the intraoperative findings, suggesting that blood from the ruptured tumor may have traversed the intact diaphragm to enter the right pleural cavity soon after the HCC rupture. However, to the best of our knowledge, no similar cases of HCC have been reported to date, and this case is thus believed to be very rare. This unusual phenomenon may therefore be strongly associated with the location of the ruptured tumor and the formation of a hematoma inside the omental bursa. We discuss the mechanism causing hemothorax in the present case and also review the previously reported cases of ruptured HCC complicated by hemothorax.

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“…Some authors consider that for lesions located beneath the diaphragm laparoscopic approach can be associated [13] or even replaced with the thoracoscopic one [14,15].…”

Section: Lrfa Advantagesmentioning

confidence: 99%

Laparoscopic Radiofrequency Ablation of Liver Tumors

Boeti¹,

Grigorie²,

Popescu³

2013

Hepatic Surgery

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Thoracoscopic Radiofrequency Ablation Therapy for Hepatocellular Carcinoma Above the Diaphragm Associated with Intractable Hemothorax

Cited by 4 publications

References 2 publications

Successful Transcatheter Arterial Embolization for Hemothorax from a Spontaneous Rupture of Hepatocellular Carcinoma Metastasis to the Chest Wall in an Elderly Patient

Successful Transcatheter Arterial Embolization for Hemothorax from a Spontaneous Rupture of Hepatocellular Carcinoma Metastasis to the Chest Wall in an Elderly Patient

Hemothorax caused by spontaneous rupture of hepatocellular carcinoma: a case report and review of the literature

Laparoscopic Radiofrequency Ablation of Liver Tumors

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