scholarly journals Clinically Silent Intracardiac Metastasis with Extremely Poor Prognosis in a Patient with Hepatocellular Carcinoma

2017 ◽  
Vol 11 (2) ◽  
pp. 416-421 ◽  
Author(s):  
Mashal Salehi ◽  
The Yee ◽  
Eric Alatevi ◽  
Yamin Thein
Keyword(s):  
Hepatocellular Carcinoma ◽  
Poor Prognosis ◽  
Vena Cava ◽  
Signs And Symptoms ◽  
Cardiac Metastasis ◽  
Advanced Hepatocellular Carcinoma ◽  
Unusual Site ◽  
Cardiac Extension ◽  
Prognostic Importance ◽  
The Right

Intracavitary cardiac extension remains an unusual site of extrahepatic metastasis in patients with hepatocellular carcinoma. While patients can present with signs and symptoms suggestive of right-sided heart failure, it may be totally asymptomatic, which is very rare with only a few cases reported so far. Also, cardiac metastasis is of great prognostic importance as patients with intracardiac metastasis can have an extremely poor prognosis. Here, we present the case of a 52-year-old male patient with advanced hepatocellular carcinoma, with an incidentally found tumor thrombus extending from the inferior vena cava to the right atrium, protruding through the tricuspid valve into the right ventricle, on routine echocardiography. The patient did not have any signs or symptoms of heart involvement and unfortunately died on the 18th day of the hospital stay.

scholarly journals Advanced Hepatocellular Carcinoma with Subtotal Occlusion of the Inferior Vena Cava and a Right Atrial Mass

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Christian Steinberg ◽  
Suzanne Boudreau ◽  
Felix Leveille ◽  
Marc Lamothe ◽  
Patrick Chagnon ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Inferior Vena Cava ◽  
Right Atrium ◽  
Inferior Vena ◽  
Vena Cava ◽  
Great Majority ◽  
Right Atrial ◽  
Advanced Hepatocellular Carcinoma ◽  
Regional Lymph Nodes ◽  
The Right

Hepatocellular carcinoma usually metastasizes to regional lymph nodes, lung, and bones but can rarely invade the inferior vena cava with intravascular extension to the right atrium. We present the case of a 75-year-old man who was admitted for generalized oedema and was found to have advanced HCC with invasion of the inferior vena cava and endovascular extension to the right atrium. In contrast to the great majority of hepatocellular carcinoma, which usually develops on the basis of liver cirrhosis due to identifiable risk factors, none of those factors were present in our patient.

scholarly journals Transarterial Radioembolization Treatment of Advanced Hepatocellular Carcinoma Invading the Right Atrium

2021 ◽  
pp. 1-4
Author(s):  
Kabalane Yammine ◽  
◽  
Sarah Khalife ◽  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Inferior Vena Cava ◽  
Right Atrium ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Vena Cava ◽  
Treatment Strategies ◽  
Complete Response ◽  
Advanced Hepatocellular Carcinoma ◽  
The Right

Tumor thrombus infiltration of hepatocellular carcinoma (HCC) into the inferior vena cava and right atrium is rare and is associated with a poor prognosis due to the critical location of the tumor and the limited efficiency of the available treatment strategies. In this study, we report the case of a patient with advanced HCC and tumor thrombus in the inferior vena cava and right atrium who demonstrated complete response with mass retraction upon Yttrium-90 trans-arterial radioembolization (90Y- TARE) therapy. Throughout the 16 months follow-ups after the radioembolization, the patient was free of any complications, revealing no occurrence of radiation-induced pneumonitis or tumor recurrence.

scholarly journals Hepatocellular Carcinoma with Vascular Invasion and Cardiac Metastasis Causing Progressive Liver and Renal Failure: A Case Report and Literature Review

2020 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Right Atrium ◽  
Inferior Vena ◽  
Vena Cava ◽  
Cardiovascular Complications ◽  
Cardiac Metastasis ◽  
Medical Treatments ◽  
Common Cancer ◽  
The Right ◽  
The Brain

Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver and eighth-most common cancer. The most frequent sites of metastasis are the lungs, the bones, the lymphatics, and the brain. An isolated metastasis of a HCC to the right atrium and inferior vena cava (IVC) is extremely rare. Here we discuss a case of a 61-year-old female who presented with two weeks of generalized weakness and was found to have advanced stage HCC with metastasis to the IVC and right atrium of her heart. We recommend that echocardiography should be routinely performed for all patients with advanced HCC because if metastasis to the right atrium is not detected early enough, the clinical course will be complicated by many unexpected cardiovascular complications that can be fatal. Currently the prognosis for this disease is very poor so further investigation into surgical and medical treatments needs to occur.

scholarly journals Advanced Stage Hepatocellular Carcinoma with Multiple Metastasis and Vascular Thrombosis: A Case of Complete Response to Sorafenib

2016 ◽  
Vol 29 (2) ◽  
pp. 139 ◽  
Author(s):  
Adélia Simão ◽  
Raquel Silva ◽  
Lurdes Correia ◽  
Filipe Caseiro Alves ◽  
Armando Carvalho ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Kinase Inhibitor ◽  
Performance Status ◽  
Evaluation Criteria ◽  
Vena Cava ◽  
Complete Response ◽  
Response To Treatment ◽  
Advanced Hepatocellular Carcinoma ◽  
And Performance ◽  
The Right

Sorafenib is a multi-targeted tyrosine kinase inhibitor, with antiangiogenic and antiproliferative properties, approved for the treatment of advanced hepatocellular carcinoma. It induces a significant increase in the median overall survival, despite a complete response to treatment being rare. We report a clinical case of a 60-year-old male with hepatic cirrhosis, Child-Pugh class A and performance status 0, and advanced hepatocellular carcinoma. The primary tumor measured 17 x 8 cm and had diffuse intrahepatic metastization, extensive lung and left adrenal invasion, as well as thrombosis of inferior vena cava, with projection to the right atrium. This patient showed a rapid and complete response to sorafenib, evaluated by mRECIST (modified Response Evaluation Criteria in Solid Tumors), that remains after three years of treatment.

scholarly journals Regression of tumor thrombus in the suprahepatic vena cava of hepatocellular carcinoma and conversion hepatectomy induced by lenvatinib

Liver Cancer ◽  
2021 ◽  
Author(s):  
Ryota Matsuki ◽  
Naohiro Okano ◽  
Takaaki Arai ◽  
Shinya Yoshiike ◽  
Masaharu Kogure ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Inferior Vena Cava ◽  
Hepatic Vein ◽  
Extracorporeal Circulation ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Vena Cava ◽  
Advanced Hepatocellular Carcinoma ◽  
Conversion Surgery ◽  
First Case

Abstract Recent developments in systemic chemotherapy for advanced hepatocellular carcinoma have been outstanding. However, reports on conversion surgery after lenvatinib therapy are scarce. We present the first case of advanced hepatocellular carcinoma with tumor thrombus in the suprahepatic vena cava close to the right atrium, which shrank after 12 weeks’ administration of lenvatinib, thereby leading to successful conversion surgery without using total vascular exclusion or extracorporeal circulation. The treatment strategy for hepatocellular carcinoma with macroscopic hepatic vein tumor thrombus is controversial, however, from a Japanese nationwide survey, surgical resection has been accepted as one of the treatment options for advanced hepatocellular carcinoma with hepatic vein tumor thrombus in Japan. However, the survival rate after resection of hepatocellular carcinoma having inferior vena cava tumor thrombus with extracorporeal circulation was reported to be worse than without extracorporeal circulation, and some preoperative down-sizing therapy for inferior vena cava tumor thrombus was advocated. Preoperative lenvatinib therapy might be a promising option among the multidisciplinary treatments for hepatocellular carcinoma with macroscopic tumor thrombus in the hepatic veins.

Iliocaval Compression Syndrome

1987 ◽  
Vol 2 (3) ◽  
pp. 173-179 ◽  
Author(s):  
Syde A. Taheri ◽  
Paul Nowakowski ◽  
David Pendergast ◽  
Julie Cullen ◽  
Steve Pisano ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Vena Cava ◽  
Signs And Symptoms ◽  
Iliac Vein ◽  
Venous Hypertension ◽  
Common Iliac Vein ◽  
Compression Syndrome ◽  
Extrinsic Compression ◽  
The Right

The iliocaval compression syndrome is a disorder, frequently found in young women, in which extrinsic compression of the left iliocaval junction produces signs and symptoms of lower extremity venous insufficiency. The anatomic variant which gives rise to this syndrome consists of compression of the left common iliac vein by the overlying right common iliac artery, near its junction with the vena cava. Additional reduction of outflow results from intraluminal venous webs and tight adhesions between the iliac artery and vein. Pain, swelling, pigmentation, and venous claudication characterize this syndrome, which affects predominantly the left leg. The syndrome may progress to iliofemoral thrombosis, phlegmasia cerulea dolens, and venous gangrene. Longstanding iliocaval stenosis may produce valvular incompetence. Exercise plethysmography is a non-invasive test useful in screening patients for iliocaval compression. The definitive diagnosis is made by venography, both ascending and descending, to determine the degree of outflow stenosis. Iliocaval patch angioplasty with retrocaval positioning of the right iliac artery, decreases venous hypertension and leads to improvement in the clinical condition. To date, we have performed iliocaval angioplasty, with retrocaval repositioning of the right common iliac artery, on 18 patients. Of these, 83% have had good results as determined by hemodynamic and clinical assessment.

scholarly journals Metastasis of hepatocellular carcinoma presented as a tumor of the maxillary sinus and retrobulbar tumor

2011 ◽  
Vol 68 (4) ◽  
pp. 359-362 ◽  
Author(s):  
Daniela Kolarevic ◽  
Zorica Tomasevic ◽  
Ivan Boricic ◽  
Dejan Rasic ◽  
Natasa Andjelic-Dekic ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Lymph Nodes ◽  
Maxillary Sinus ◽  
Poor Prognosis ◽  
Postoperative Radiotherapy ◽  
Extrahepatic Metastasis ◽  
Histopathological Analysis ◽  
Dental Surgery ◽  
Tumor Mass ◽  
The Right

Introduction. Hepatocellular carcinoma (HCC) is the most frequent primary malignant tumor of the liver. It is usually seen in the 6th and 7th decades of life and chronic hepatitis B is the most frequent cause. Extrahepatic metastasis of HCC is an indicator of a poor prognosis and the most common sites are lungs, bones, lymph nodes, kidneys and adrenal glands. We reported a case of isolated metastasis in the right maxilla, which had been found initially, before the tumor in the liver was diagnosed. Case report. A 70-year-old man underwent dental surgery of the upper right molar. Prolonged bleeding control was difficult for up to two weeks, so the biopsy was performed. Histopathological analysis revealed a metastatic hepatocellular carcinoma. Computerized tomography (CT) of the abdomen revealed a diffusely heterogeneous liver parenchyma with irregular borders and two foci of mass lesions. There were metastasis in the spleen and also two pathological retroperitoneal lymph nodes were detected, but no ascit, liver cirrhosis, cholestasis or portal vein thrombosis were seen. CT of the orbital and maxillary regions revealed a tumor mass in the right maxillary sinus, spreading to the alveolar sinus, nasal cavity and partially infratemporal space. A tumor mass was in the right orbit as well, infiltrating the surrounding bones and muscles. Clinically, there was proptosis of the right eye accompanied by amaurosis. The treatment started with chemotherapy based on 5-fluorouracil (sorafenib was not available). After three cycles, control CTs showed a stable disease in the liver, but progression in the right maxillary sinus and orbit. Enucleation of the right eye was performed and postoperative radiotherapy was planed. The patient deteriorated rapidly and died, about 6 months after the disease had been diagnosed. Conclusion. Extrahepatic metastasis of HCC represents a progressive phase of the disease with poor prognosis, so the main aim of the treatment should be palliation and care of symptoms.

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