Abstract

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.

• Keywords: Intra-arterial chemotherapy;Hepatocellular carcinoma with inferior vena cava and right atrium involvment