Zhang ZY, Zhang EL, Zhang BX, Zhang W. Surgery for hepatocellular carcinoma with tumor thrombosis in inferior vena cava: A case report. World J Clin Cases 2021; 9(36): 11495-11503 [PMID: 35071583 DOI: 10.12998/wjcc.v9.i36.11495]
Corresponding Author of This Article
Wei Zhang, MD, Assistant Professor, Research Laboratory and Hepatic Surgery Center, Department of Hepatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Road, Wuhan 430000, Hubei Province, China. weizhangtjh@hust.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Zun-Yi Zhang, Er-Lei Zhang, Bi-Xiang Zhang, Wei Zhang, Research Laboratory and Hepatic Surgery Center, Department of Hepatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
Author contributions: Zhang ZY performed the majority of the writing and prepared the figures and tables; Zhang EL and Zhang BX performed data and writing accusation; Zhang W designed the outline of this paper.
Supported bythe National Natural Science Foundation of China, No. 81802767 and No. 81860117.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, and there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Zhang, MD, Assistant Professor, Research Laboratory and Hepatic Surgery Center, Department of Hepatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Road, Wuhan 430000, Hubei Province, China. weizhangtjh@hust.edu.cn
Received: August 19, 2021 Peer-review started: August 19, 2021 First decision: September 5, 2021 Revised: September 25, 2021 Accepted: November 14, 2021 Article in press: November 14, 2021 Published online: December 26, 2021 Processing time: 126 Days and 3.6 Hours
Abstract
BACKGROUND
Hepatocellular carcinoma (HCC) accompanied by a tumor thrombus is very common. However, the treatment strategy is controversial and varies by the location of the thrombus.
CASE SUMMARY
We report herein a case of HCC with a tumor thrombus in the suprahepatic inferior vena cava (IVC), which was successfully treated by hepatectomy combined with thrombectomy following sorafenib chemotherapy. A 47-year-old woman with chronic hepatitis was diagnosed with HCC. Computed tomography and magnetic resonance imaging showed that the tumor lesion was located in the right half of the liver, and a tumor thrombus was detected in the suprahepatic IVC near the right atrium. After multi-departmental discussion and patient informed consent, right major hepatectomy and total removal of the tumor thrombus were successfully performed under cardiopulmonary bypass. There were no serious complications after surgery. Following sorafenib treatment, no recurrence has been detected so far (11 mo later).
CONCLUSION
Surgical treatment followed by adjuvant sorafenib therapy might be an acceptable choice for HCC patients with tumor thrombosis in the IVC.
Core Tip: Hepatocellular carcinoma (HCC) is the most common type of liver cancer with a high mortality rate worldwide. For HCC patients with tumor thrombosis in the inferior vena cava (IVC), in addition to tumor progression, acute pulmonary embolism induced by tumor thrombosis is also a vital factor decreasing patient survival. Once a pulmonary embolism occurs, there is no effective therapy, and the patients usually die. Therefore, in Asia-Pacific regions such as China, Japan and South Korea, surgical treatment is recommended in highly selected patients, which might provide better survival outcomes than other treatments. Here, we report a case of a resectable HCC patient with tumor thrombosis in the IVC who was treated successfully by liver resection, tumor thrombosis removal and systemic treatment.
