A Successfully Resected Case of Hepatocellular Carcinoma with Tumor Thrombus Extending into the Right Atrium and Intrahepatic Metastasis in Aposit Lobe

Chifumi Maruyama, Masakazu Yamamoto, Masashi Tsugita, Takehito Otsubo, Hideo Katsuragawa, Kazuyuki Takenami, Ken Takasaki

Institute of Gastroenterology, Tokyo Women's Medical College

In a 62-year-old man with known abdominal distension and lower extremity edema, abdominal computed tomographic scan confirmed the diagnosis of hepatosellularcarcinoma in the right lobe with tumor thrombus extending into the right atrium and intrahepatic metastasis to the left lobe. We administered chemotherapy, consisting of CDDP 100 mg by means of hepatic arterial infusion. After chemotherapy, the tumor thrombus in the right atrium receded such that the distal portion was no longer in the right atrium, but rather in the inferior vena cava. The intrahepatic metastasis disappeared. Right hepatectomy extirpation of the inferior vena caval tumor thrombus was performed. Simultaneously, we identified cecal cancer necessitating ileocecal resection. The patient died of dissemination due to recurrence of the cecal cancer, without evidence of hepatocellularcarcinoma recurrence, 19 months after the operation.

Key words
hepatocellular carcinoma, intraatrial tumor thrombus, intraarterial neo-adjuvant chemotherapy

Reprint requests
Chifumi Maruyama Institute of Gastroenteroloty, Tokyo Women's Medical College
8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162 JAPAN

Accepted
February 12, 1997

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