Membranous obstruction of the inferior vena cava (MOVC) is a rare subset of Budd-Chiari syndrome (BCS) with a subacute onset that is often complicated by cirrhosis and hepatocellular carcinoma (HCC). Here we report a case of recurrent HCC in a patient with cirrhosis and BCS that was treated with several episodes of transarterial chemoembolization followed by surgical tumorectomy, whereas the MOVC was successfully treated with balloon angioplasty followed by endovascular stenting. The patient was followed up for 9.9 years without anticoagulation and experienced no stent thrombosis. After the tumorectomy, the patient was HCC-free for 4.4 years of follow-up.
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Multidisciplinary collaboration successfully treated Budd Chiari syndrome complicated with hepatocellular carcinoma rupture and bleeding: A case report Lian Liao, Yuyang Qiu, Xiaobo Gong Medicine.2025; 104(51): e46748. CrossRef
With the advances in hepatocellular carcinoma (HCC) treatment, the lung metastasis of HCC is becoming increasingly important. In treating the lung metastasis of HCC, a multidisciplinary approach can lead to better results than systemic chemotherapy alone. Here, we report on a patient who presented with pulmonary masses, while the HCC was being controlled in the abdominal cavity. The presence of nontuberculous mycobacteria was identified during the diagnosis of the pulmonary masses. The pulmonary metastases of HCC were treated with a combination of angiotherapy, radiation therapy, and radiofrequency ablation. The patient showed a satisfactory progress with this multidisciplinary localized treatment. We report the clinical progress and review the recent literature regarding the treatment of pulmonary metastasis without intrahepatic HCC herein.
In patients with hepatocellular carcinoma (HCC) or liver cirrhosis (LC) accompanied by hepatitis E virus (HEV) infection, hepatic failure often leads to debility. Here, we report about a 63-year-old man with alcoholic LC who was referred to our hospital with jaundice and abdominal distension 10 days earlier. Abdominal computed tomography showed necrotic HCC accompanied by left lobe shrinkage without tumor progression. Laboratory and imaging findings revealed no acute infection focus. The patient reported no herbal medicine or alcohol consumption, and there was no evidence of acute viral hepatitis. One month later, HEV immunoglobulin M positivity was confirmed, and deterioration of liver function due to HEV infection was suspected. The patient often ate raw oysters and sashimi, as well as boar meat, which is a well-known risk food for HEV infection. His umbilical hernia deteriorated due to tense ascites and infection by skin abrasion. The patient progressed to hepatorenal syndrome and eventually died. Liver function preservation is important when treating HCC patients. Therefore, clinicians should pay more attention to the prevention of HEV and others causes of direct liver injury.
A prognosis of hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is dismal
that the median survival is 2 to 4 months without treatment. Sorafenib, the standard regimen of
advanced HCC, can prolong median survival only 1.5 months. A 50-year-old man with a history
of chronic hepatitis B was diagnosed advanced HCC with PVTT. By a multidisciplinary medical
team approach, the combination of 3-demensional conformal radiation therapy with sequential
sorafenib was challenged. 4 months after initiation of treatment, he achieved partial response
as modified response evaluation criteria in solid tumors criteria. Sorafenib was continued so
far, and stable disease has been maintained up to now, without significant adverse effect.
Sorafenib is a multi-targeted tyrosine kinase inhibitor that inhibits Raf kinase and the
vascular endothelial growth factor receptor intracellular kinase pathway and is the first
agent to demonstrate a statistically significant improvement in overall survival for patients
with advanced hepatocellular carcinoma (HCC). However, there were few cases of partial or
complete response reported in the previous studies. We herein report a case of dramatic
partial response in a patient who had advanced HCC with multiple lung metastasis and portal
vein thrombosis treated with sorafenib.