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首页> 外文期刊>Oncology, Gastroenterology and Hepatology Reports >Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava and Right Atrium
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Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava and Right Atrium

机译：下部静脉腔和右心房中有肿瘤血栓的肝细胞癌

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We present a rare case of hepatocellular carcinoma with associated tumor thrombus that extends into the inferior vena cava and right atrium. Our patient presented with lower extremity edema and an elevated D-dimer. CT pulmonary angiography showed no signs of pulmonary embolism however it showed large filling defects involving the inferior vena cava, right atrium, right ventricle and superior vena cava suggestive of an extensive thrombus. On subsequent imaging studies it was identified as a tumor thrombus as opposed to a blood thrombus. A tumor thrombus is a rare complication more commonly associated with renal cell carcinoma and carries a poor prognosis. Surgical thrombectomy is considered the first line of treatment at this time, however, due to the low number of known cases to have IVC and RA involvement, there is little consensus on management. Often patients are referred for microwave ablation. Anti-coagulation is not the treatment of choice for a tumor thrombus however we speculate there may be a role for anti-coagulation.
机译：我们目前罕见的肝癌伴有相关的肿瘤血栓，延伸到下腔静脉和右心房。该患者出现下肢水肿和D-二聚体升高。 CT肺血管造影未见肺栓塞的迹象，但显示出较大的充盈缺损，涉及下腔静脉，右心房，右心室和上腔静脉，提示广泛的血栓。在随后的影像学研究中，它被鉴定为是肿瘤血栓，而不是血液血栓。肿瘤血栓是一种罕见的并发症，更常见于肾细胞癌，预后较差。外科血栓切除术目前被认为是治疗的第一线，但是，由于已知病例中有IVC和RA参与的病例较少，因此在治疗上尚无共识。通常将患者转诊进行微波消融。抗凝不是治疗肿瘤血栓的一种选择，但是我们推测抗凝可能有一定作用。

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