scholarly journals Large inferior vena cava tumor with cardiac extension revealed by venous thrombembolism in a patient with complete situs inversus: what are the odds?

2021 ◽  
Vol 31 (1) ◽  
pp. 85-89
Author(s):  
Diana-Andreea Roscaneanu ◽  
Ovidiu Mitu ◽  
Daniela Crisu ◽  
Radu-Stefan Miftode ◽  
Mihai Stefan Cristian Haba ◽  
...  

Venous thromboembolism (VTE) can be the fi rst symptom of an occult malignancy in apparently healthy individual. Inferior vena cava (IVC) tumors are rare conditions but with negative prognosis. We present the case of a 57 year-old male patient, with complete situs inversus, diagnosed with hepatic cirrhotic disease and frequent decompensations, that was hospitalized for deep venous thrombosis (DVT) and ascites. Further imagistic investigations revealed a 22 cm tumor inside the IVC with consequent Budd-Chiari syndrome that was actually causing the liver and kidney disease, extending from the infrarenal level to the right atrium. After compensation, the patient was referred to a multidisciplinary surgical team. However, the management of such patients is very diffi cult, and the prognosis is altered. Possible IVC leiomyosarcoma are very rare and such vascular extension has been rarely reported.

2021 ◽  
pp. 153857442110020
Author(s):  
Reza Talaie ◽  
Hamed Jalaeian ◽  
Nassir Rostambeigi ◽  
Anthony Spano ◽  
Jafar Golzarian

Budd-Chiari syndrome (BCS) results from the occlusion or flow reduction in the hepatic veins or inferior vena cava and can be treated with transjugular intrahepatic portosystemic shunt when hepatic vein recanalization fails.1-3 Hypercoagulable patients with primary BCS are predisposed to development of new areas of thrombosis within the TIPS shunt or IVC. This case details a patient with BCS, pre-existing TIPS extending to the right atrium, and chronic retrohepatic IVC thrombosis who underwent sharp recanalization of the IVC with stenting into the TIPS stent bridging the patient until his subsequent hepatic transplantation.


2005 ◽  
Vol 19 (12) ◽  
pp. 723-728 ◽  
Author(s):  
Joanna K Law ◽  
Jenny Davis ◽  
Anne Buckley ◽  
Baljinder Salh

Intrahepatic cholangiocarcinoma, an increasingly recognized primary tumour of the liver, is associated with a very poor prognosis. A patient with this tumour who presented with Budd-Chiari syndrome (the first to the authors' knowledge in Western literature and only the third patient overall) secondary to extensive thrombosis in his inferior vena cava extending from the right atrium down to his iliac vessels is described. Neither curative nor palliative intervention was deemed to be an option in this patient, who deteriorated rapidly while on anti-coagulants. Postmortem examination confirmed the radiological findings, and histological analysis revealed characteristic appearances of this tumour within the biliary tree and invasion into the inferior vena cava. Furthermore, biliary dysplasia, which can be a precursor to this cancer, was also noted within some of the bile ducts.


2021 ◽  
pp. 47-55
Author(s):  
Edward Castro-Santa ◽  
Hellen Daniela Siles-Víquez ◽  
Karla Castro-Solano ◽  
Javier Brenes-González ◽  
María A. Matamoros

We herein report the challenging evaluation and planning process involved in performing the first successful surgical resection of a renal tumor with extensive inferior vena cava tumor thrombosis reaching the right atrium in a pediatric patient within the Central American region. In November 2018, the Oncology Department of the National Children’s Hospital in Costa Rica consulted our Center for Liver Transplantation and Hepatobiliary Surgery for the evaluation of a clinical case involving a 6-year-old female patient with progressive Budd-Chiari syndrome caused by a Wilms’ tumor of the right kidney with tumor thrombosis of the inferior vena cava reaching the right atrium. A multistage surgical safety strategy combining liver transplant techniques and cardiac surgery was thereafter designed and implemented, achieving complete excision of the tumor thrombus from the inferior vena cava with right nephrectomy. Postoperatively, the patient exhibited complete clinical resolution of Budd-Chiari syndrome and has remained tumor free with excellent quality of life while pursuing her second grade of primary school education 22 months after the successful implementation of this multistage surgical safety strategy. The combination of liver transplantation techniques and cardiac surgery based on a multistage surgical safety strategy minimized the occurrence of unexpected intraoperative events and allowed for complete renal tumor resection and level IV thrombectomy for the first time in a pediatric patient of a public health system in a developing country within the Central American region.


1996 ◽  
Vol 4 (3) ◽  
pp. 142-145
Author(s):  
Rajiv Agarwal ◽  
Upendra Kaul ◽  
Pradeep Jain ◽  
Sanjeev Sharma ◽  
Sanjiv Sharma ◽  
...  

Ten patients (mean age 36.6 ± 8 years; 5 male) with idiopathic inferior vena cava obstruction underwent balloon angioplasty, followed by placement of a self-expanding stent. Six had total occlusion, 5 had restenosis (including 2 with total occlusion), and I had a suboptimal result after initial dilatation. The mean diameter of the inferior vena cava increased from 1.5 ± 2.1 mm to 14.4 ± 2.7 mm, and the pressure gradient between the vena cava and the right atrium decreased from 15.2 ± 5.0 mm Hg to 1.1 ± 1.5 mm Hg. Follow-up venography after 74 ± 35 days in 6 patients, revealed ho restenosis, with further enlargement of the mean diameter by 5.2 ± 3.1 mm (44 ± 35%) and abolition of pressure gradients. One patient died 6 months after the procedure from acute Budd-Chiari syndrome. Autopsy revealed a widely patent stent with hepatic vein thrombus. Stent implantation is useful in the management of inferior vena cava obstruction with prior restenosis, total occlusion, or suboptimal results of balloon angioplasty.


2021 ◽  
pp. 112972982110501
Author(s):  
Gabriel Stefan ◽  
Simona Stancu ◽  
Adrian Zugravu ◽  
Laura Predescu ◽  
Simona Cinca ◽  
...  

Budd-Chiari syndrome due to the tip of an internal jugular tunneled dialysis catheter malposition in inferior vena cava or hepatic vein is a rare complication. We aimed to present our experience and compare it with the previous reports to highlight the clinical features and the optimal management. A 57-year-old female with history of ANCAp vasculitis, treated by hemodialysis in the last 2 years on a right internal jugular vein tunneled catheter was admitted for pain in the right upper quadrant. A subacute Budd-Chiari syndrome due to catheter malposition was diagnosed. The catheter was removed, and a new tunneled hemodialysis line was inserted in the right internal jugular vein with the tip at the junction of right atrium with superior vena cava. Anticoagulation with apixaban 2.5 mg twice daily was started after catheter replacement and the patient was discharged. At 1 month follow-up the patient had no symptoms, and the ultrasound revealed the absence of the thrombus in the inferior vena cava. Imagining monitoring for malposition after insertion or in a clinical context suggestive for Budd-Chiari syndrome is essential for early diagnosis and treatment. In our case, anticoagulation with apixaban and prompt catheter replacement resulted in Budd-Chiari syndrome resolution.


2013 ◽  
Vol 7 (06) ◽  
pp. 489-493 ◽  
Author(s):  
Sami Akbulut ◽  
Mehmet Yilmaz ◽  
Aysegul Kahraman ◽  
Sezai Yilmaz

Budd-Chiari syndrome is an uncommon disorder characterized by the thrombotic or non-thrombotic obstruction of hepatic venous outflow anywhere along the venous course from the hepatic venules to the junction of the inferior vena cava and the right atrium. The etiology of Budd-Chiari syndrome is classified as primary, attributable to intrinsic intraluminal thrombosis or the development of venous webs; or secondary, caused by intraluminal invasion by a parasite or malignant tumor or extraluminal compression by an abscess, solid tumor, or cyst, such as a hydatid cyst. In this study, we present a case of a giant hydatid cyst manifesting Budd-Chiari syndrome symptoms and signs by compressing the inferior vena cava and hepatic veins. In brief, the case demonstrates that hydatid disease should be considered in the differential diagnosis of Budd-Chiari Syndrome in areas such as Turkey, where hydatid disease is endemic.


MedPharmRes ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 22-26
Author(s):  
Uyen Vo ◽  
Duc Quach ◽  
Luan Dang ◽  
Thao Luu ◽  
Luan Nguyen

Budd–Chiari syndrome (BCS), a rare and life-threatening disorder due to hepatic venous outflow obstruction, is occasionally associated with hypoproteinemia. We herein report the first case of BCS with segmental obstruction of the intrahepatic portion of inferior vena cava (IVC) and hepatic veins (HVs) successfully treated by endovascular stenting in Vietnam. A 32-year-old female patient presented with a 2-month history of massive ascites and leg swelling. She refused history of oral contraceptives use. Hepatosplenomegaly without tenderness was noted. Laboratory data showed polycythemia, mild hypoalbuminemia and hypoproteinemia, slightly high total bilirubin and normal transaminase level. The serum ascites albumin gradient was 1.9 g/dL and ascitic protein level was 1.1 g/dL. The other data were normal. BCS was suspected because of the discrepancy between mild liver failure and massive ascites; and the presence of hepatosplenomegaly and polycythemia. On abdominal magnetic resonance imaging, the segmental obstruction of three HVs and IVC was 2-3 cm long without thrombus. Cavogram revealed the severe segmental stenosis of intrahepatic portion of IVC with no visualized HV and extensive collateral veins. A Protégé stent was deployed to IVC. Leg swelling and ascites were completely resolved within 3 days after stenting. During 1-year follow-up, edema was not recurred and repeated laboratory results were all normal.


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