Key result
Among 10 HCC patients with IVC/right atrium tumor thrombi without hepatic vein invasion, the thrombi were supplied by the right inferior phrenic artery (n=8) or the right internal mammary artery (n=2).
Why the study?
To clarify the clinical and radiological features of isolated tumor thrombi in the inferior vena cava or right atrium in patients with HCC without hepatic vein invasion.
What are the clinical and radiological features of isolated tumor thrombi in the IVC/right atrium in patients with HCC without hepatic vein invasion?
Observational (n=7,704)
What are the clinical and radiological features of isolated tumor thrombi in the IVC/right atrium in patients with HCC without hepatic vein invasion?
HCC invading the phrenic vein can present with tumor thrombi in the IVC/right atrium without hepatic vein invasion, a condition that is frequently misdiagnosed on pre-procedural CT.
Answers are grounded in this paper and cite their sources.
May prompt angiographic search for phrenic or internal mammary supply in suspected isolated IVC/RA thrombi; leaves open embolization strategies in HCC.
AIM: To clarify the clinical and radiological features of isolated tumor thrombi in the inferior vena cava (IVC)/right atrium in patients with hepatocellular carcinoma (HCC) without hepatic vein invasion. PATIENTS AND METHODS: In this retrospective study, from January 2007 to December 2019, a total of 35,163 chemoembolization sessions were performed in 7,704 patients with HCC. Among them, 10 (0.13%) patients had tumor thrombi in the IVC/right atrium without definitive hepatic vein invasion. Computed tomographic (CT) scans, digital subtraction angiograms, and cone-beam CT images were retrospectively reviewed and interpreted. RESULTS: The tumor thrombi were supplied by the right inferior phrenic artery (n=8) or the right internal mammary artery (n=2). Follow-up CT scans in eight patients showed linear accumulation of iodized oil along the diaphragm, which was presumed to be a thrombosis of the phrenic vein. Retrospective review of formal radiological reports of pre-procedural CT scans revealed that a correct diagnosis of tumor thrombi of the IVC/right atrium was made in only three cases. CONCLUSION: HCC invading the phrenic vein may have tumor thrombi in the IVC/right atrium without hepatic vein invasion.
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Kim et al. (2021) conducted an observational in Hepatocellular carcinoma (n=7,704). Chemoembolization was evaluated on Radiological features and arterial blood supply of tumor thrombi. Among 10 HCC patients with IVC/right atrium tumor thrombi without hepatic vein invasion, the thrombi were supplied by the right inferior phrenic artery (n=8) or the right internal mammary artery (n=2).
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