Hepatocellular Carcinoma in a Patient with Budd-Chiari Syndrome

Takehiro Nishiki, Kazuo Chijiiwa, Koutaro Matsumoto, Kazuhiro Kondo, Shuichiro Uchiyama and Kouki Nagaike

Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine

Hepatocellular Carcinoma associated with Budd-Chiari Syndrome (BCS) is a relatively rare disease. A 52 year old woman was admitted to the hospital complaining of a bronchial asthma , and liver tumor, splenomegaly, and the dilatation of the azygos vein, and ascending lumbar vein were incidentally found. She was referred to our hospital for further examination and treatment. Hepatocellular carcinoma, 5 cm in size, was detected in the segment 5 of the liver. The chest enhanced CT demonstrated the membranous obstruction of the inferior vena cava at the level of the diaphragm. A cavography additionally showed the development of collateral vein, ascending lumbar vein and azygos vein, that communicated with the superior vena cava . BCS associated with hepatocellular carcinoma was evident. Partial resection of the liver was carried out. No treatment was applied to the membranous stricture of the caval vein because of little pressure defference between the inferior vena cava and superior vena cava and of the absence of portal hypertension. We herein report a case of hepatocellular carcinoma associated with BCS and discuss the treatment strategy.

Key words
Budd-Chiari syndrome, hepatocellur carcinoma, liver cirrhosis

Reprint requests
Kazuo Chijiiwa Department of Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine
5200 Kihara, Kiyotake, Miyazaki, 889-1692 JAPAN

Accepted
February 28, 2007

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