Long-term survival after chemoembolization of metastatic right atrial tumor thrombus as a presenting feature of hepatocellular carcinoma: A case study.
Long-term survival after chemoembolization of metastatic right atrial tumor thrombus as a presenting feature of hepatocellular carcinoma: A case study.
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DOI：
10.3892/ol.2012.618
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发表时间：
2012-05
期刊：
影响因子：
2.9
通讯作者：
Junhui Sun;Yue-Lin Zhang;C. Nie;Li-ming Chen;Jian-di He;Wei-Lin Wang;Shu-sen Zheng
中科院分区：
文献类型：
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作者：
Junhui Sun;Yue-Lin Zhang;C. Nie;Li-ming Chen;Jian-di He;Wei-Lin Wang;Shu-sen Zheng
经肝静脉侵犯心脏的晚期肝细胞癌是一种罕见的疾病，预后极差。出现右心肿瘤血栓的患者通常被认为不能手术。虽然以前曾进行过积极的切除和肝移植治疗，但结果仍然不令人满意。然而，肝细胞癌延伸至心脏通常是经导管动脉化疗栓塞术(TACE)的禁忌症。本文报告一例罕见的肝细胞癌合并下腔静脉(IVC)和右房(RA)癌栓转移的病例。这位年轻患者因布-加综合征住进我科。根据CT影像和实验室资料确诊后，患者接受了TACE治疗。这种治疗导致肝肿瘤和右心房肿瘤血栓明显减少。经TACE治疗后，患者存活3年零10个月，无任何复发迹象。此病例表明TACE治疗晚期肝癌合并心脏癌栓是可行的，并有可能获得长期生存。
Advanced hepatocellular carcinoma (HCC) with invasion into the heart through the hepatic vein is a recognized rare occurrence with an extremely poor prognosis. Patients who present with right heart tumor thrombus have generally been considered inoperable. Although aggressive resection and liver transplantation treatment have previously been performed, the results remain unsatisfactory. However, HCC with extension into the heart usually indicates a contraindication for transcatheter arterial chemoembolization (TACE). In this study, a rare case of HCC with metastatic inferior vena cava (IVC) and right atrial (RA) tumor thrombus was reported. The young patient was admitted to our department due to Budd-Chiari syndrome. Following diagnosis according to CT image findings and laboratory data, the patient underwent TACE therapy. This treatment resulted in a marked reduction in the liver tumor and the right atrial tumor thrombus. Following TACE therapy, the patient survived for 3 years and 10 months and remains alive without any signs of recurrence. This case indicates that TACE therapy can be used successfully for the treatment of advanced HCC with heart tumor thrombus and may result in long-term survival.