Oncale Melody, Lewis Brian
Department of Internal Medicine (Oncale) and the Department of Hematology and Medical Oncology (Lewis), Tulane University Hospitals and Clinics, New Orleans, Louisiana. Dr. Oncale is now affiliated with Oschner Health System.
Proc (Bayl Univ Med Cent). 2015 Apr;28(2):229-30. doi: 10.1080/08998280.2015.11929240.
Hepatocellular carcinoma (HCC) is the third-leading cause of cancer-related mortality worldwide. Most cases of HCC are associated with cirrhosis from various causes such as alcohol or viral hepatitis. Most patients are symptomatic as a result of cirrhosis itself or secondary to tumor extension. These tumors have an affinity for the vasculature and often invade the portal system. HCC rarely causes invasion of the inferior vena cava or the heart. We, however, present a case of HCC in a patient without cirrhosis who remained asymptomatic despite having tumor extension to the heart by way of the inferior vena cava. The mean survival in patients with intracardiac extension with or without aggressive treatment or intervention is approximately 4 months, but our patient greatly exceeded survival expectations after treatment with sorafenib.
肝细胞癌（HCC）是全球癌症相关死亡的第三大原因。大多数HCC病例与各种原因（如酒精或病毒性肝炎）引起的肝硬化有关。大多数患者因肝硬化本身或肿瘤扩散继发症状。这些肿瘤对脉管系统有亲和力，常侵犯门静脉系统。HCC很少侵犯下腔静脉或心脏。然而，我们报告了一例无肝硬化的HCC患者，尽管肿瘤通过下腔静脉扩散至心脏，但仍无症状。有或无积极治疗或干预的心脏内扩散患者的平均生存期约为4个月，但我们的患者在接受索拉非尼治疗后大大超过了生存预期。
