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Bouattour M, Mehta N, He AR, Cohen EI, Nault JC. Systemic Treatment for Advanced Hepatocellular Carcinoma. Liver Cancer. 2019; 8(5): 341.

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Article

Complicated HCC - A Case of IVC Thrombosis

1Department of Internal Medicine, NYC Health & Hospitals (Harlem), New York, USA


American Journal of Medical Case Reports. 2021, Vol. 9 No. 9, 441-444
DOI: 10.12691/ajmcr-9-9-2
Copyright © 2021 Science and Education Publishing

Cite this paper:
Ismail Malik, Ibrahim Omore, Kesiena Akpoigbe, Abimbola Fadairo-Azinge, Luqman Salahudeen. Complicated HCC - A Case of IVC Thrombosis. American Journal of Medical Case Reports. 2021; 9(9):441-444. doi: 10.12691/ajmcr-9-9-2.

Correspondence to: Ismail  Malik, Department of Internal Medicine, NYC Health & Hospitals (Harlem), New York, USA. Email: dejimalique@gmail.com

Abstract

Hepatocellular cancer (HCC) is known to be among one of the commonest primary liver tumors globally with rising incidence and it is often implicated as a frequent cause of cancer-related death. It usually carries a poor prognosis because it is not often diagnosed early until the advanced stages of the disease with distant metastatic spread, vascular invasion, and thrombus formation. The pathophysiologic evolution of HCC is complicated involving prolonged inflammatory damage with sequelae of hepatocyte necrosis, regeneration, and fibrosis. Involvement of the vasculature portends a dismal outcome (less than 6 month survival) although inferior vena cava (IVC) tumor thrombus occur far less commonly than portal and hepatic veins. This can present a significant challenge in patient management despite advances in diagnostic and therapeutic modalities, due to late clinical presentation and lack of consensus regarding treatment. We report a 71-year old man who presented with syncope with incidental finding of large hepatocellular cancer with IVC thrombosis. Following extensive workup, the patient was ineligible for surgical intervention and was referred for chemoembolization with possible immunotherapy. This case highlights vigilance for occult malignant processes in patients that may present atypically.

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