Journal of Liver Cancer

Case Reports

Long-term Disease-free Survival after Trimodality Treatment of Recurrent Hepatocellular Carcinoma Involving the Inferior Vena Cava and Right Atrium: Sunmin Park, Won Sup Yoon, Hyung Joon Yim, Chai Hong Rim; J Liver Cancer. 2019;19(2):149-153. Published online September 30, 2019; DOI: https://doi.org/10.17998/jlc.19.2.149

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Abstract PDF Supplementary Material: Hepatocellular carcinoma (HCC) involving the inferior vena cava (IVC) and/or right atrium (RA) is a rare and intractable disease. A standard treatment has not been established yet, owing to the rarity of disease and difficulties in the therapeutic treatment. Herein, we report the case of a patient who had recurrent HCC (after a prior lobectomy) involving both IVC and RA and underwent multimodality treatments including external beam radiotherapy and transarterial chemotherapy, followed by sorafenib treatment. The disease was well controlled with local treatments and sustained for 7 years until last follow-up after the systemic treatments. Our case shows a possibility of long-term survival for patients affected by HCC involving IVC and/or RA, after a rigorous multimodality treatment strategy.

Sorafenib Treatment in Advanced Hepatocellular Carcinoma with Tumor Thrombus Nearly Occupying the Entire Right Atrium: Kang, Young Mo , Ryu, Soo Hyung , Lee, Bo Kyung , Ko, Kyoung Ho , Park, Tae Young , Moon, Jeong Seop , Cho, Seon Hwa; J Liver Cancer. 2018;18(2):142-145. Published online September 30, 2018; DOI: https://doi.org/10.17998/jlc.18.2.142

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Advanced hepatocellular carcinoma (HCC) with tumor thrombus extending through the hepatic veins, inferior vena cava, and right atrium (RA) is very rare. However, whether active treatments such as radiation, transcatheter arterial chemoembolization, and sorafenib in advanced HCC with RA involvement prolong survival is uncertain. We present a rare case of advanced HCC with tumor thrombus nearly occupying the entire RA that was treated with sorafenib. The patient received 400 mg sorafenib twice daily. However, her liver enzyme levels continued to increase and abdominal computed tomography showed an increase in the tumor size in the liver and RA. In the present case, active treatment with sorafenib was ineffective; thus, palliative care may be more beneficial in advanced HCC with extensive RA involvement.

Citations

Citations to this article as recorded by

Hepatocellular Carcinoma with Hepatic Vein and Inferior Vena Cava Invasion
Akash Shukla, Abhinav Jain
Journal of Clinical and Experimental Hepatology.2023; 13(5): 813. CrossRef
Clinical outcome and toxicity of radiotherapy for inferior vena cava tumor thrombus in HCC patients
So Jung Lee, Hong Seok Jang, Yoo Kyung Choi
Medicine.2021; 100(25): e26390. CrossRef
miR‐4454 Promotes Hepatic Carcinoma Progression by Targeting Vps4A and Rab27A
Haoming Lin, Rui Zhang, Wenrui Wu, Liming Lei, Grzegorz Węgrzyn
Oxidative Medicine and Cellular Longevity.2021;[Epub] CrossRef

A Case of Hepatocellular Carcinoma with Tumor Thrombus in Inferior Vena Cava and Right Atrium: Hyun Jung Lee, Hyung Joon Yim, Hwan Hoon Chung, Seung Hwa Lee, Hae Rim Kim, Jong Jin Hyun, Sung Woo Jung, Ja Seol Koo, Sang Woo Lee, Jai Hyun Choi; Journal of the Korean Liver Cancer Study Group. 2012;12(2):141-145. Published online September 30, 2012

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Abstract PDF: In patients with advanced hepatocellular carcinoma (HCC), tumor thrombus in inferior vena cava (IVC) and right atrium (RA) are not uncommon findings and are usually associated with extremely poor outcome. Although aggressive surgical interventions such as extracorporeal circulation and tumor excision have been performed, the reported results were still unsatisfactory. Herein, we report the favorable result of combined treatment with radiation therapy and transarterial chemoembolization in a patient with advanced HCC with extensive tumor thrombus through the IVC into the RA. In conclusion, noninvasive combined modalities, such as transarterial chemoembolization and radiation therapy may sometimes provide effective palliation for patients with far advanced HCC with IVC/RA tumor thrombus and who are not candidates for alternative treatment options.

A Case of Successful Hepatic Resection for Hepatocellular Carcinoma with Tumor Thrombus Extending into the Right Atrium: Yong Beom Cho, Kuhn Uk Lee, Hyo-Suk Lee, Hyuk Ahn, Hae Won Lee, Eung-Ho Cho, Sung-Hoon Yang, Jai Young Cho, Nam-Joon Yi, Kyung-Suk Suh; Journal of the Korean Liver Cancer Study Group. 2006;6(1):25-27. Published online June 30, 2006

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Abstract PDF: Hepatocellular carcinoma (HCC) with extension of its tumor thrombus into the inferior vena cava (IVC) and right atrium has been regarded as beyond the realm of surgical resection. It could cause sudden death due to pulmonary embolism or heart failure by the detached fragments of tumor thrombus. In recent years, successful surgery has been reported for hepatic malignancies with its tumor thrombus to the IVC and right atrium by some centers of Taiwan and Japan. We also did a successful en bloc resection of the liver tumor and its tumor thrombus in the IVC and right atrium using cardiopulmonary bypass and report herein.

A Case of Advanced Hepatocellular Carcinoma with Inferior Vena Cava and Right Atrium Invasion Treated with Intra-arterial Chemotherapy: Kee Myung Lee, Je Han Won, Deok Kee Kim, Jae Geun Kim, Won Seok Kim, Kwang Hyeon Ko, Sung Won Cho; Journal of the Korean Liver Cancer Study Group. 2001;1(1):107-109. Published online June 30, 2001

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Abstract PDF: A 52 year-old-male patient was admitted to our hospital due to hematemesis. Ten years ago, he had been diagnosed chronic hepatitis B and he was heavy alcoholics. He was in the state of SB tube insertion and we had esophagogastroduodenoscopy and found out cardiac varix bleeding and injected history1. On abdominal ultrasonograpy, large hypoechoic mass in left lobe of liver was noted and the mass invaded into hepatic vein, inferior vena cava (IVC), and right atrium. On hepatic arteriography, large hypervascular mass in left lobe of the liver and several small dodules in right lobe were noted. We performed chemoembolization to the nodules in right lobe but cannot performed to the lesion in left love due to arteriovenous shunt. We inserted the chemport catheter to proper hepatic artery and started the intra-arterial chemotherapy (IACT) with 5-FU 250 mg and cisplatin 10 mg for 5 days. After the second cycle of IACT, tumor thrombus in right atrium was disappeared and thrombus in IVC and tumor mass in left lobe were decreased in size. We believed that hepatocellular carcinoma of this patient should be sensitive to chemotherapy and planned the additional IACT treatment.

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