Atrial reconstruction, distal gastrectomy with Ante-situm liver resection and autotransplantation for hepatocellular carcinoma with atrial tumor thrombus: A case report. Issue 19 (14th May 2021)

• Record Type: Journal Article
• Authors: Tuxun, Tuerhongjiang; Apaer, Shadike; Yao, Gang; Wang, Zhipeng; Gu, Shensen; Zeng, Qi; Aizezijiang, Aidan; Wu, Jing; Anweier, Nuerzhatijiang; Zhao, Jinming; Li, Tao
• Other Names: Saranathan. Maya section editor.
• Is Part Of: Medicine. Volume 100:Issue 19(2021)
• Publication Date: 2021-05-14
• Subjects: ante-situm -- autotransplantation -- hepatocellular carcinoma -- radical resection -- tumor thrombi; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000025780
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Hepatocellular with tumor thrombi extending into 3 hepatic veins (HVs) and right atrium presents as a real clinical challenge. We report the first documented case of surgical resection of an advanced hepatocellular carcinoma (HCC) with extensive invasion to distal stomach, atrium and hepatic vasculatures. Patient concerns: We present a case of 48-years old man with abdominal mass accompanying shortness of breath after activities. Diagnoses: Preoperative examination revealed giant HCC with tumor thrombi extending into portal vein, HVs, inferior vena cava, and atrium. Interventions: Distal stomach involvement was confirmed at surgery and, distal gastrectomy, atrial reconstruction and ante-situm liver resection and autotransplantation under cardio-pulmonary bypass were performed. Outcomes: The operation time was 490 minutes, extracorporeal circulation time 124 minutes, and anhepatic time 40 minutes. Postoperative follow-up revealed normal hepatic and cardiac function with no sign of recurrence. Lessons: This case illustrates that the extensive invasion of HCC to major vasculature and adjacent organs may not necessarily preclude the liver autotransplantation with multi-visceral resection as the treatment option of extremely advanced HCC patients.