Cases reported "Carcinoma, Hepatocellular"

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1/233. Primary liver carcinoma complicating membranous obstruction of the inferior vena cava.

    A rare autopsy case of primary liver carcinoma complicating a pre-existing, incomplete membranous obstruction of the inferior vena cava (MOVC) is reported. The patient, a 67-year-old Japanese male, was admitted to hospital following a 2 year illness of a left chest wall tumor and a 3 month illness with progressive abdominal pain. Computed tomography scans of the abdomen displayed space-occupying lesions in the third and seventh hepatic segments, respectively. One month later, the patient developed edema of the lower extremities and marked venous dilatation of the abdominal trunk. At that time, Doppler examination revealed the presence of intrahepatic large venovenous collaterals. The patient subsequently succumbed 82 days after hospitalization. At subsequent autopsy, the inferior vena cava was completely obstructed by tumor thrombus, which was formed caudally and cranially to a thin membrane and mimicked the valve, with calcification and elastic lamina, at the phrenic portion. Intrahepatic large collateral pathways were found between submembranous and supramembranous hepatic veins. Anomalous absence of the ostia of the middle hepatic vein was found. In addition, the portal venous trunk was occluded by tumor thrombus. histology of hepatic tumors revealed a combined hepatocellular and cholangiocellular carcinoma in the non-cirrhotic liver with severe acute centrilobular congestion. In MOVC patients such as the case presented, malignancy-induced thrombosis was deemed to be an important factor in prognosis.
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ranking = 1
keywords = thrombosis, vein
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2/233. Extended hepatectomy with ePTFE graft vena caval replacement and hepatic vein reconstruction: a case report.

    A 69 year-old man with a history of thoracoplastic surgery for pulmonary tuberculosis, who required a blood transfusion and subsequently tested positive for hepatitis c virus, developed a right hypochondrial mass, swelling of the lower extremities and malaise. A huge hepatocellular carcinoma invading the suprahepatic vena cava with tumor thrombi was diagnosed radiographically. An extended right hepatectomy with supra- to retrohepatic IVC resection was performed in an en bloc fashion using a centrifugal pump for hepatic vascular exclusion (HVE). The supra- to retrohepatic IVC was replaced with an expanded polytetrafluoroethylene (ePTFE) graft, 20 mm x 10 cm in size, and the left hepatic venous confluence was reconstructed. Twenty-one months after surgery, the patient is in good condition without recurrence of tumor.
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ranking = 0.69674930778311
keywords = vein
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3/233. An aged male patient with autoimmune hepatitis complicated by hepatocellular carcinoma.

    An 82-year-old male patient was admitted for liver dysfunction. Laboratory test showed the following data; aspartate aminotransferase (AST) 79 IU/l, alanine aminotransferase (ALT) 28 IU/l, total bilirubin (T. Bil) 0.9 U, zinc sulfate turbidity test (ZTT) 48.9 U, gamma-globulin 4.9 g/dl, immunoglobulin g (IgG) 5,046 mg/dl, anti-nuclear antibodies x 320, anti-mitochondrial antibodies (-), hepatitis b virus surface antigen (HBsAg) (-), HBcAb (-), anti-hepatitis c virus (anti-HCV) (-), hepatitis c virus (HCV-rna) (-), anti-hepatitis G virus (anti-HGV) (-), alpha-fetoprotein 306.8 ng/ml, carcinoembryonic antigen (CEA) 2.3 ng/ml, carbohydrate antigen (CA) 19-9 77.2 U/ml. Abdominal ultrasonography and computed tomography showed a large mass occupying most of the right lobe and portal thrombosis in the liver. liver biopsy revealed cirrhosis with inactive hepatitis in the nontumorous lesion and well-differentiated hepatocellular carcinoma in the tumorous lesion. We report a rare case of an aged male patient with autoimmune hepatitis complicated by hepatocellular carcinoma.
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ranking = 0.65162534610844
keywords = thrombosis
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4/233. Recurrent hepatocellular carcinoma successfully treated with radiofrequency thermal ablation.

    We report a patient with hepatocellular carcinoma (HCC) who was successfully treated with radiofrequency thermal ablation (RFA). A 71-year-old man was admitted to our hospital in August 1996 with recurrence of HCC. Partial hepatic resection had been performed in January 1993 for HCC that had measured 1.3 cm in segment VIII, and subsequently he had received six sessions of percutaneous ethanol injection (PEI) for treatment of recurrence. Dynamic computed tomography (CT) performed in August 1996 showed two recurrent tumors, one measuring 3.8 cm in segment VIII adjacent to the right hepatic vein, and one measuring 2.0 cm in segment V. Three sessions of percutaneous RFA were performed. After this treatment, most of the tumor in segment VIII and all the tumor in segment V showed low density on dynamic CT, and the right hepatic vein was preserved. However, a remnant of the mass appeared near the right hepatic vein 2 months after the treatment. An additional two sessions of RFA were performed. After the end of treatment, serum alpha-fetoprotein level dropped to the normal range, and no sign of recurrence has been observed until September 1998.
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ranking = 0.52256198083734
keywords = vein
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5/233. hypertension as a paraneoplastic syndrome in hepatocellular carcinoma.

    We report a 66-year-old man with hepatocellular carcinoma who was positive for hepatitis B surface antigen, and was hospitalized because of hypoglycemia and hypertension. His plasma renin activity was normal (2.3 ng/ml per h), but concentrations of angiotensin i (>2500 pg/ml) and II (86 pg/ml) were high. Increased angiotensin i level at sites proximal and distal from the confluence of the hepatic vein and the inferior vena cava indicated that the hypertension was provoked by overproduction of angiotensin i from the hepatocellular carcinoma. Previous reports of patients with hepatocellular carcinoma with hypertension due to abnormality of renin-angiotensin system are reviewed.
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ranking = 0.17418732694578
keywords = vein
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6/233. Arterialisation of the portal vein with an aortoportal jump graft for portal vein thrombosis following liver resection for malignancy.

    Fibrolamellar hepatocellular carcinoma (FHCC) is a variant of hepatocellular carcinoma, which mainly affects a young age group and carries a relatively good prognosis. It is widely accepted that aggressive curative resection is still the best option for FHCC. We report here a case of successful arterialisation of the portal vein with an aortoportal jump graft for portal vein thrombosis, which developed postoperatively in an already comprised portal vein with tumour invasion following an extensive liver resection for FHCC.
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ranking = 6.503682252996
keywords = thrombosis, vein thrombosis, vein
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7/233. An embryological perspective on congenital portacaval shunt: a rare anomaly in a patient with hepatocellular carcinoma.

    We describe a 42-yr-old woman with hepatocellular carcinoma and a congenital portacaval shunt. A computed tomography (CT) scan of the abdomen showed a prominent left hepatic lobe extending into the lower abdomen. A large encapsulated, necrotic-appearing mass was seen within the right hepatic lobe. The patient underwent hepatic resection, during which the continuation of the confluence of the splenic and superior mesenteric veins was found to empty directly into the inferior vena cava, bypassing the hepatic parenchyma. An extended right hepatic lobectomy was performed with a complete excision of the mass (T3 N0 M0, stage III). The patient had an uneventful postoperative course. To our knowledge, this is the first reported case of this anomaly in a living adult having undergone hepatectomy.
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ranking = 0.17418732694578
keywords = vein
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8/233. Combined hepatocellular and cystadenocarcinoma presenting as a giant cyst of the liver--a case report.

    Primary cystic lesions of the liver are very rare. Most of the solid tumours are hepatocellular carcinomas (HCC) with a smaller number being cholangiocarcinomas. The association of HCC with other primary liver malignancies is also extremely rare. This case report is about a 27 year old male patient who presented with a giant cystic lesion of the left liver. A CT scan showed a cystic lesion with internal septations and a thrombus in the main portal vein. The patient underwent an extended left hepatectomy and a portal venotomy with removal of the thrombus. Coexistent hepatocellular and cystadenocarcinoma were reported on histopathological examination. The patient was put on 5-FU postoperatively. He is doing well 11 months after surgery.
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ranking = 0.17418732694578
keywords = vein
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9/233. Wischnewski ulcers and acute pancreatitis in two hospitalized patients with cirrhosis, portal vein thrombosis, and hypothermia.

    Accidental hypothermia has been described in the forensic literature but reports of occurrence in hospitalized patients are rare. Associated anatomic lesions include acute hemorrhagic pancreatitis and characteristic acute gastric ulcers termed Wischnewski ulcers. We report here two patients with cirrhosis and ascites; one also had hepatocellular carcinoma. portal vein thrombosis, acute hemorrhagic pancreatitis and Wischnewski ulcers were present in both. The clinical records documented hypothermia that progressed over several days. temperature nadirs of 31.0 degrees C (87.8 degrees F) and 32.2 degrees C (90.0 degrees F) were recorded in each patient, respectively, one day before death, although each transiently reached temperatures that did not register on standard monitoring devices. This is the first report that chronicles antemortem body temperatures in hypothermic patients with Wischnewski ulcers and pancreatitis at autopsy. Also, the association of these findings with portal vein thrombosis and cirrhosis has not been previously described. We discuss this constellation of findings with regard to possible mechanistic interrelations.
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ranking = 6.5502699495856
keywords = thrombosis, vein thrombosis, vein
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10/233. Percutaneous ethanol injection as a possible curative treatment for malignant portal vein thrombosis in hepatocellular carcinoma.

    Postoperative residual hepatocellular carcinoma (HCC) with malignant portal vein thrombosis in a 48-year-old man was cured with transarterial chemoembolization (TACE) for the parenchymal portion and percutaneous ethanol injection (PEI) for the malignant portal vein thrombosis. No evidence of tumor recurrence was noted after 18 months of follow-up. The only severe complication in our patient was biliary stricture which was treated with an internal stent via endoscopic retrograde pancreatico-cholangiography (ERCP).
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ranking = 6.2843709643755
keywords = thrombosis, vein thrombosis, vein
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