Open AccessSuccessful management of the hepatocellular carcinoma with inferior vena cava tumor thrombus
Author(s) -
Yuanjun Liu,
Kunlin Xie,
Jiaxin Li,
Zhi Wang,
Yong Zeng,
Hong Wu
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000026081
Subject(s) - medicine , hepatocellular carcinoma , inferior vena cava , sorafenib , radiology , thrombus , surgery
Rationale: Hepatocellular carcinoma (HCC) with inferior vena cava tumor thrombus (IVCTT) is traditionally considered an advanced-stage cancer with a poor prognosis. There is no standard treatment for patients diagnosed as HCC with IVCTT. Patient concerns: A 52-year-old man was admitted to our hospital because of suspected hepatic mass during a health examination. Diagnoses: Computed tomography (CT) showed a hepatic mass approximately 4.3 cm × 6.3 cm in size located in segment VII of the liver, with thrombus in the inferior vena cava. The mass exhibited a pattern of early enhancement and washout on contrast-enhanced CT. Alpha-fetoprotein was 614.1 ng/mL (normal value, <8 ng/mL). The preoperative diagnosis was HCC with IVCTT. Interventions: Two months after stereotactic body radiotherapy combined with sorafenib therapy, a planned open anatomical resection of the right posterior lobe of the liver was performed. Outcomes: The patient is alive without disease 12 months after surgery, and the level of alpha-fetoprotein is normal. Lessons: The patient diagnosed as HCC with IVCTT was successfully treated by stereotactic body radiotherapy combined with molecularly targeted drugs followed by surgical treatment. If confirmed in future studies, this would suggest a promising strategy for the management of HCC with IVCTT.