Hepatocellular Carcinoma with Tumor Thrombus Extending into the Right Atrium Report of a Successful Resection

Toshiharu Tsuzuki, Kozo Kawada, Masakazu Ueda, Shin Takahashi, Kunio Nakayasu, Hiromasa Ishii, Kyoichi Hiramatsu, Yukio Tashiro

Departments of Surgery, Medicine, Radiology and Pathology, Keio University School of Medicine

Patients with hepatocellular carcinoma with tumor thrombus extending into the right atrium usually die within a short period. The only way to treat these patients is to resort to hepatic resection with removal of the tumor thrombus under cardiopulmonary bypass. A 57-year-old man had a tumor, 4 cm in diameter, in the left medial segment of his cirrhotic liver with tumor thrombus extending from the middle hepatic vein into the right atrium. The patient underwent resection of the left medial segment and part of the right anterior segment with removal of the tumor thrombus. He was discharged from hospital with uneventful recovery but died of recurrence in the remnant liver five months after surgery. It was proved that the surgery was technically feasible. Long-term survival is now the issue.

Key words
hepatocellular carcinoma, tumor thrombus in the right atrium, liver resection

Reprint requests
Toshiharu Tsuzuki Department of Surgery, Keio University School of Medicine
35 Shinanomachi, Shinjuku-ku, Tokyo, 160 JAPAN

Accepted
July 10, 1990

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