A Case of Hepatocellular Carcinoma with Intracaval Extension of Tumor Emboli from Middle Right Hepatic Vein

Ryusei Matsuyama, Yasuhiro Sumi, Suguru Sawada, Katsutoshi Murase, Naomasa Yoshida and Yutaka Ozeki

Department of Surgery, Tosei National Hospital

We report a case of hepatocellular carcinoma (HCC) with tumor emboli in the inferior vena cava (IVC). A 51-year-old man suffering from HCC due to HBV cirrhosis since 3 years previously and undergoing TAE and percutaneous ethanol injection (PEI) several times was referred to our hospital for surgery for recurrent HCC. Abdominal CT in July 2000 showed a 3 cm tumor in segment 7 that extended to the IVC through the middle right hepatic vein (MRHV). The tumor continuously formed 4.0 cm emboli in the IVC in August 2000. Right hepatic lobectomy and tumor emboli removal were conducted by total hepatic vasculr exclusion (THVE). His postoperative course was uneventful and he was discharged on postoperative day 24. THVE is useful in HCC embolectomy, which extended to the IVC, provides a survival benefit for patients. We recommend the operation for HCC with tumor emboli into the IVC because of the improved quality of life (QOL).

Key words
hepatocellular carcinoma, tumor emboli, middle right hepatic vein

Reprint requests
Ryusei Matsuyama Department of Surgery, Tosei National Hospital, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka, 411-8611 JAPAN

Accepted
January 30, 2002

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