Abstract
Two patients with advanced hepatocellular carcinoma presented severe exertional dyspnea because of extension of a tumor into the right side of the heart. Removable of the tumor thrombus by open-heart surgery ameliorated the symptoms in each case, but their subsequent courses differed considerably. One patient survived for as long as 8 months thanks to successive multidisciplinary treatments, whereas the other patient died suddenly 1 month after the surgery. The first patient's hepatocellular carcinoma was more differentiated, and the dyspnea was caused by a low cardiac output due to the intracardiac tumor mass, not by pulmonary embolism as in the second patient's case. We conclude that successive multidisciplinary treatments to control the growth of hepatocellular carcinoma is the most important approach and is indispensable for improving the prognosis.
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Abbreviations
- HBV:
-
hepatitis B virus
- TAE:
-
transarterial embolization
- AFP:
-
α-fetoprotein
- PIVKA:
-
protein induced by vitamin K absence
- FDP:
-
fibrinogen/fibrin degradation products
- CT:
-
computerized tomography
- MRI:
-
magnetic resonance imaging
References
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Fujisaki M, Kurihara E, Kikuchi K, Nishikawa K (1991) Hepatocellular carcinoma with tumor thrombus extending into the right atrium: report of a successful resection with the use of cardiopulmonary bypass. Surgery 109: 214
Kato Y, Tanaka N, Kobayashi K, Ikeda T (1983) Growth of hepatocellular carcinoma into the right atrium. Ann Intern Med 99: 472
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Masaki, N., Hayashi, S., Maruyama, T. et al. Marked clinical improvement in patients with hepatocellular carcinoma by surgical removal of extended tumor mass in right atrium and pulmonary arteries. Cancer Chemother. Pharmacol. 33 (Suppl 1), S7–S11 (1994). https://doi.org/10.1007/BF00686660
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DOI: https://doi.org/10.1007/BF00686660