Cases reported "Liver Neoplasms"

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1/453. Efficacy of applied cardiovascular surgery techniques for extended resection in hepato-biliary-pancreatic malignancies.

    The application of extracorporeal circulation (ECC) and vascular surgery techniques provide the possibility to resect severely advanced hepato-biliary-pancreatic (HBP) malignancies that had been adjudged unresectable hitherto. In this paper, recent two successful cases are reported for the purpose of indicating the efficacy of ECC and vascular surgery techniques in HBP surgery. Two patients had a cholangiocellular carcinoma and a carcinoma of the pancreatic head, those metastatic lymph nodes invaded to the portal veins and the hepatic arteries. These tumors could be resected en bloc with these Glissonian vessels using a centrifugal pump through veno-venous bypass. Reconstruction of these portal veins was performed with autologous external iliac vein graft. Postoperative angiographies showed no anastomotic leakage or occlusion on vascular anastomotic sites in both cases, and they have gone on uneventful postoperative courses. Application of cardiovascular techniques in the field of HBP surgery might expand surgical indication for advanced malignancies.
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keywords = vein
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2/453. 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 = 1.5891819177301
keywords = thrombosis, vein
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3/453. 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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keywords = vein
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4/453. 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 = 0.92251525106346
keywords = thrombosis
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5/453. 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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keywords = vein
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6/453. 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 = 0.33333333333333
keywords = vein
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7/453. Islet cell tumor of the pancreas associated with tumor thrombus in the portal vein.

    We report the MR findings of a 70-year-old man with an islet cell tumor that diffusely involved the body of the pancreas associated with enhancing portal vein tumor thrombus and cavernous transformation. The diffusely infiltrative tumor mass was best shown on early post gadolinium spoiled gradient echo. The tumor thrombus enhanced intensely on early post gadolinium images and was also well shown on true FISP (Fast Imaging with Steady State Precession) images. The extent of liver metastases was best shown on fat suppressed T2-weighted images. The most unusual finding was tumor thrombus involving the SMV and portal vein.
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ranking = 2
keywords = vein
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8/453. Left extended hemihepatectomy with preservation of large inferior right hepatic vein: a case report.

    For hepatic function to be preserved after an extended hemihepatectomy adequate venous drainage of the remaining liver is required. Most metastases close to the confluence of the superior hepatic veins are considered unresectable because hepatic venous outflow after resection would be compromised. In 10-25% of people, the inferior right hepatic vein is of large calibre. Thus the superior hepatic veins may be sacrificed and hepatic function preserved if a large inferior right hepatic vein is present. A patient with involvement of segments 2, 4 and 8 by metastatic colorectal cancer is presented. This patient had a large inferior right hepatic vein, and so was able to undergo an extended left hemihepatectomy with ligation of all superior hepatic veins. Subsequent quality of life was maintained. This case illustrates that an 'unresectable' hepatic lesion can be actually resectable if an alternative venous drainage is present. A pre-operative search for a prominent inferior right hepatic vein by ultrasound, computerised tomography, or even magnetic resonance imaging should be considered in these cases.
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ranking = 3.6666666666667
keywords = vein
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9/453. 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 = 9.4860823366509
keywords = thrombosis, vein, vein thrombosis
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10/453. Epithelioid hemangioendothelioma with marked liver deformity and secondary budd-chiari syndrome: pathological and radiological correlation.

    A case of malignant epithelioid hemangioendothelioma of the liver in a 48-year-old woman with severe portal hypertension and marked deformity of the liver is presented. This woman had a history of mild liver dysfunction since the age of 30 years, and abdominal distention, esophageal varices, splenomegaly and ascites since October 1996. Imaging examinations revealed liver deformity with severe atrophy of the left lobe and the anterior segment of the right lobe. Celiac arteriography showed narrowing and upward deviation of the proper hepatic artery, and occlusion of the left and right anterior hepatic arteries. Since March 1997, hepatic venography showed stenosis in the right hepatic vein truncus. budd-chiari syndrome was clinically diagnosed. She died in June 1997. The autopsy disclosed massive tumor embolism in the left and right anterior portal branches, few in the hepatic artery, and occlusion of the left and right anterior hepatic arteries. The extensive tumor embolism resulted in portal hypertension, and atrophy of the left lobe. The anterior segment of the right lobe was probably caused by the occlusion of both the hepatic arteries and the portal veins. The posterior segment of the right lobe, without massive tumor embolism in its portal branch, appeared hypertrophic.
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keywords = vein
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