Chuma Masashi, Fukumoto Takumi, Kusunoki Nobuya, Tsuchida Shinobu, Kido Masahiro, Takahashi Masanori, Tsugawa Daisuke, Awazu Masahide, Kataoka Yoko, Matsumoto Ippei, Hori Yuichi, Kuroda Daisuke, Ku Yonson
Dept. of Surgery, Kobe University Hospital.
Gan To Kagaku Ryoho. 2010 Nov;37(12):2300-2.
We herein report a case of advanced hepatocellular carcinoma (HCC) with Vp4 portal vein thrombosis (PVTT). All of the hepatic tumors have completely disappeared for more than two years by a dual treatment with reductive surgery plus percutaneous isolated hepatic perfusion (PIHP). A 68-year-old man was referred to our institution in May 2009. The abdominal CT scan demonstrated massive HCC in the right robe of the liver with PVTT reaching the portal trunk (Vp4). We semi-electively performed a right hepatectomy together with thrombectomy of the PVTT. Subsequently, we underwent a PIHP (doxorubicin 90 mg/m2). This resulted in normalization of serum AFP and PIVKA-II levels. Dual treatment is considered to be the strongest therapeutic modality for multiple advanced HCC with severe PVTT.
我们在此报告一例伴有Vp4门静脉血栓形成（PVTT）的晚期肝细胞癌（HCC）病例。通过减瘤手术联合经皮肝隔离灌注（PIHP）的双重治疗，所有肝肿瘤已完全消失超过两年。一名68岁男性于2009年5月转诊至我院。腹部CT扫描显示肝右叶有巨大HCC，PVTT延伸至门静脉主干（Vp4）。我们半选择性地进行了右肝切除术及PVTT取栓术。随后，我们进行了PIHP（阿霉素90mg/m²）。这使得血清甲胎蛋白（AFP）和异常凝血酶原（PIVKA-II）水平恢复正常。双重治疗被认为是伴有严重PVTT的多发晚期HCC最强有力的治疗方式。
