Vishnevsky V A, Korostelev A N, Efanov M G, Subbotin V V, Iliyn S A, Sitnikov A V, Rashchepkin K E, Gritsyuta A Yu
Institute of Surgery named after A.V. Vishnevsky, Moscow, Russia.
Moscow Clinical Research Centre, Moscow, Russia.
Angiol Sosud Khir. 2015;21(3):159-65.
Presented herein is a case report concerning tumorous thrombosis of the inferior vena cava and right atrium, which is rather an uncommon but severe complication of primary hepatic cancer. The purpose of the article is to demonstrate successful surgical management of locally disseminated hepatic carcinoma complicated by tumorous thrombosis of the inferior vena cava and portal vein, as well as thrombosis of the right atrium. The patient was subjected to dextral hemihepatectomy with thrombectomy from the right portal vein, resection of the right cupola of the diaphragm, marginal resection of the lower lobe of the right lung, thrombectomy from the inferior vena cava and right atrium. The outcome of our case report, as well as literature data suggest that in case of resectability of hepatic tumour complicated by thrombosis of major vessels and even the heart, surgical intervention is justified if there is a possibility to completely remove thrombotic masses along with the primary tumour.
本文介绍了一例关于下腔静脉和右心房肿瘤性血栓形成的病例报告,这是原发性肝癌一种相当罕见但严重的并发症。本文的目的是展示对局部播散性肝癌合并下腔静脉和门静脉肿瘤性血栓形成以及右心房血栓形成的成功手术治疗。该患者接受了右半肝切除术,同时进行了右门静脉取栓术、右膈顶切除术、右肺下叶边缘切除术、下腔静脉和右心房取栓术。我们的病例报告结果以及文献数据表明,对于合并大血管甚至心脏血栓形成的可切除性肝肿瘤,如果有可能连同原发性肿瘤一起完全清除血栓性肿块,手术干预是合理的。