J Liver Cancer.  2020 Sep;20(2):148-153. 10.17998/jlc.20.2.148.

Long-term Survival of a Patient with a Large Hepatocellular Carcinoma with Main Portal Vein Tumor Thrombosis and Spontaneous Tumor Rupture

• Lee HW
• Kim GA
• Oh CH
• Shim JJ
• Kim BH

• KMID: 2508026
• DOI: http://doi.org/10.17998/jlc.20.2.148

Abstract

Optimal treatments for patients with advanced hepatocellular carcinoma (HCC) are still limited and their prognosis remains dismal. Yet, there have been rare cases that have shed light on longer survival in these patients assisted by various treatments. This paper aims to present an extraordinary case of far advanced HCC that had been properly managed in spite of continuous recurrence. A patient visited the hospital with a ruptured large HCC with main portal vein tumor thrombosis but survived longer than 14 years owing to active and prompt interventions.

Keyword

Carcinoma; Hepatocellular; Chemoembolization; Therapeutic; Long-term care

Figure

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  Figure 1 Initial abdomen computed tomography images. (A) arterial phase, (B) portal phase and (C) delayed phase, showing a huge liver mass in the left lobe with hemoperitoneum due to hepatic tumor rupture, measuring 16.5 cm and thrombus extending from the distal main portal to the left portal vein.

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  Figure 2 Positron emission tomography-computed tomography scan showing recurrent metastatic hepatocellular carcinomas at the left upper lobe of the lung (A, arrow) and para aortic lymph node (B, arrow) at 16 months following surgical resection.

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  Figure 3 A recurrent hepatocellular carcinoma at segment 8 following repeated transcatheter arterial chemoembolization (fifth and sixth). (A) Arterial phase (arrow), (B) delayed phase (arrow).

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  Figure 4 Liver magnetic resonance imaging images showing recurrent hepatocellular carcinomas (arrow) in an arterial phase. After 8 years of the first hepatic resection, multiple tumors recurred at segment 5 and 8.

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  Figure 5 Case summary showing tumor location and treatments for 15 years. TACE, transcatheter arterial chemoembolization; CR, complete remission; CTx, chemotherapy; FAP, fluorouracil, adriamycin, and cisplatin; PD, progressive disease; RT, radiotherapy; PVT, portal vein thrombosis.

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