Hepatocellular Carcinoma with Budd-Chiari Syndrome and Obstructive Jaundice Treated by Multiple Inte

• 作 者: WenguiLiu
• 机 构: Jiangsu Province Hospital of TCM, Nanjing University of Chinese Medicine
• 出 处: 中华放射学学术大会2016、中华医学会第23次全国放射学学术大会暨中华医学会第24次全国影像技术学术大会
• 发表日期: 2016年5期
• 关键词: hepatocellular carcinoma stent TACE PTCD long-term survival

　　Background: Most of the hepatocellular carcinomas(HCCs)are hypervascular tumor with a strong tendency to invade the venous system.HCC patient with major vascular invasion was generally considered as extremely poor prognosis.There was no article had described that HCC patient with inferior vena cava(IVC)and hepatic vein tumor thrombus and obstructive jaundice treated by interventional technique alone had obtained a survival time longer than 10 years.Case Presentation: A 64-year-old man diagnosed with Budd-Chiari syndrome caused by HCC was referred to our hospital in July 2004.Patients functional status improved and body edema decreased markedly after the placement of metallic stents within the IVC and right hepatic vein.The hypervascular hepatic tumor was controlled well subsequently by three courses of transarterial chemoembolization(TACE)alone.However,many new hypervascular nodules emerged in the liver 2.5 years later.Another two courses of TACE were employed and these nodules were under-controlled again.The similar diagnosis and treatment courses occurred in subsequent December 2008,June 2011 and August 2012,respectively.In September 2014,Enhanced computed tomography showed that a hypovascular hepatic tumor in the hepatic hilar region obstructed the common bile duct with the metastasis in the duodenum.Percutaneous transhepatic cholangial drainage and two courses of TACE were performed,however,conceivable therapeutic efficacy did not occur this time.Conclusions: Hepatocellular carcinoma patients with major vasculatures invasion,stent placement in time could be a good choice and a subsequent chemoembolization could be another appropriate choice.