Hepatocellular carcinoma tumor thrombus entering the inferior vena cava treated with percutaneous RF ablation: a case report.
Gatti P1, Giorgio A2, Ciracì E1, Roberto I1, Anglani A3, Sergio S4, Rizzello F5, Giorgio V6, Semeraro S7.
1. Internal Medicine Division, Ostuni Hospital, Ostuni, BR, Italy.
2. Interventional Ultrasound Unit, Tortorella Clinical Hospital, Salerno, Italy.
3. Radiodiagnostic Unit, Ostuni Hospital, Ostuni, BR, Italy.
4. Interventional Radiology Unit, Perrino Hospital, Brindisi, Italy.
5. Anesthesiology and Reanimation Unit, Ostuni Hospital, Ostuni, BR, Italy.
Hepatocellular carcinoma (HCC) is the most common form of liver cancer. In advanced cancer stages (metastatic disease and/or vascular invasion), the generally accepted standard of care is systemic therapy using sorafenib as first-line treatment and, recently, regorafenib and nivolumab as second-line treatment, but the quality of life and the prognosis of patients remain very poor. Our paper reports a case of US-guided radiofrequency ablation (RFA) of both intraparenchymal HCC and inferior vena cava tumor thrombus.
We treated a patient with HCC associated with tumor thrombus extending into vena cava after failure of sorafenib therapy using US-guided radiofrequency ablation (RFA).
A good radiological and clinical response was observed in association with excellent tolerability. The patient has been followed up for 15 months from the ablation, is alive, and is in a good clinical condition without evidence of tumor recurrence.
This is the first case in which this minimally invasive percutaneous procedure has been successfully used to treat an HCC thrombus entering the vena cava.