Transjugular biopsy case report of inferior vena cava hepatocellular carcinoma with intracardiac extension

Weinberg, Laurence; Abu-ssaydeh, Diana; MacGregor, Chris; Wang, Jason; Wong, Clarence; Spanger, Manfred; Muralidharan, Vijayragavan

doi:10.1016/j.ijscr.2017.08.057

Cited by 5 publications

(2 citation statements)

References 39 publications

(35 reference statements)

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“…However, this diagnostic delay can be prevented by performing early echocardiography to look for cardiac involvement in patients with a large tumor burden of HCC. A definitive diagnosis of a heart mass as metastatic HCC can be made by performing cardiac catheterization and obtaining a biopsy sample [11]. This may ultimately lead to the use of potentially useful procedures with survival benefits such as hypofractionated radiotherapy and surgery with embolectomy for HCC associated with tumor thrombus formation, which could improve the overall condition and improve progression-free survival of patients [10].…”

Section: Discussionmentioning

confidence: 99%

A Rare Incidence of Hepatocellular Carcinoma With Tumor Thrombus Extending to the Right Heart

Amin,

Shahab,

Qazi

et al. 2023

Cureus

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Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths and the sixth most commonly diagnosed cancer worldwide due to several common risk factors, including hepatitis C virus (HCV), hepatitis B virus (HBV), and other causes of cirrhosis. In HCC, intrahepatic vascular invasion and a tumor thrombus are commonly observed. However, the extrahepatic spread of the tumor thrombus to the heart via the portal vein, hepatic vein, and inferior vena cava (IVC) is rarely reported and is considered a poor prognostic factor. In addition, rarely, there is a risk of cor pulmonale and thromboembolism of the pulmonary vessels. Our patient also presented with this rare complication of HCC. Our patient's clinical presentation was bilateral pedal edema, moderate ascites, and abdominal discomfort with raised jugular venous pressure. These signs and symptoms are related to an impairment of the right heart caused by intracardiac tumor thrombus metastasis, leading to diastolic dysfunction. Based on these findings, echocardiography and abdominal computed tomography (CT) scan were performed with the definitive diagnosis of hepatocellular carcinoma with tumor thrombus metastases in the hepatic vein, inferior vena cava, and right atrium. The management team agreed on a conservative treatment plan based on the advanced stage of the disease and the high risk associated with aggressive treatment modalities.Unfortunately, on day 7 of admission, the patient died from a possible pulmonary embolism that led to cardiopulmonary arrest. This case underscores the importance of screening patients with a high HCC tumor burden with abdominal ultrasound and echocardiography for early detection and timely management.

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Section: Discussionmentioning

confidence: 99%

A Rare Incidence of Hepatocellular Carcinoma With Tumor Thrombus Extending to the Right Heart

Amin,

Shahab,

Qazi

et al. 2023

Cureus

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“…These include transcatheter aspiration, 5 brush biopsy, 6 scoop biopsy, 7 endoscopic biopsy forceps, Simpson atherectomy catheter, 8 endomyocardial bioptome, and trucut biopsy using the transjugular liver biopsy set. 9 The transcatheter aspiration and brush biopsy are techniques of the past. They provide a small sample suitable only for cytology.…”

Section: Discussionmentioning

confidence: 99%

Trucut Biopsy of a Solitary Focal Metastatic Superior Vena Cava Thrombus via Percutaneous Transjugular Approach Using Real-Time Fluoroscopic Needle Visualization in Two Planes

Narkhede

Yadav

Gangwani

et al. 2018

J Clin Interv Radiol ISVIR

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).Presentation of metastasis as a solitary focal lesion at an intravascular location is encountered quite infrequently. Owing to its intravascular location, accessing the lesion for sampling and obtaining an adequate amount of tissue are technically difficult. Among the various methods of obtaining an adequate sample from intravascular lesions, scoop and trucut biopsies appear to be safer and more advantageous. The authors present a case of a 65-year-old woman with symptoms of superior vena cava syndrome secondary to a solitary focal fluorodeoxyglucose (FDG)-avid thrombus within the superior vena cava lumen 14 years after complete remission of breast carcinoma. This lesion was approached via transjugular venous access and biopsied under fluoroscopic guidance with continuous contrast injection and real-time needle visualization in two planes. AbstractKeywords ► intravascular biopsy ► intracaval metastasis ► superior vena cava syndrome

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Use of transvenous biopsy of tumor thrombus for the diagnosis of Wilms tumor

Lai¹,

Wilson²,

Gurria³

et al. 2022

Journal of Pediatric Surgery Case Reports

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Transjugular biopsy case report of inferior vena cava hepatocellular carcinoma with intracardiac extension

Cited by 5 publications

References 39 publications

A Rare Incidence of Hepatocellular Carcinoma With Tumor Thrombus Extending to the Right Heart

A Rare Incidence of Hepatocellular Carcinoma With Tumor Thrombus Extending to the Right Heart

Trucut Biopsy of a Solitary Focal Metastatic Superior Vena Cava Thrombus via Percutaneous Transjugular Approach Using Real-Time Fluoroscopic Needle Visualization in Two Planes

Use of transvenous biopsy of tumor thrombus for the diagnosis of Wilms tumor

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