Complicated HCC - A Case of IVC Thrombosis

Ismail Malik^1, , Ibrahim Omore¹, Kesiena Akpoigbe¹, Abimbola Fadairo-Azinge¹ and Luqman Salahudeen¹

¹Department of Internal Medicine, NYC Health & Hospitals (Harlem), New York, USA

Cite this paper

Ismail Malik, Ibrahim Omore, Kesiena Akpoigbe, Abimbola Fadairo-Azinge and Luqman Salahudeen. Complicated HCC - A Case of IVC Thrombosis. American Journal of Medical Case Reports. 2021; 9(9):441-444. doi: 10.12691/AJMCR-9-9-2

Abstract

Hepatocellular cancer (HCC) is known to be among one of the commonest primary liver tumors globally with rising incidence and it is often implicated as a frequent cause of cancer-related death. It usually carries a poor prognosis because it is not often diagnosed early until the advanced stages of the disease with distant metastatic spread, vascular invasion, and thrombus formation. The pathophysiologic evolution of HCC is complicated involving prolonged inflammatory damage with sequelae of hepatocyte necrosis, regeneration, and fibrosis. Involvement of the vasculature portends a dismal outcome (less than 6 month survival) although inferior vena cava (IVC) tumor thrombus occur far less commonly than portal and hepatic veins. This can present a significant challenge in patient management despite advances in diagnostic and therapeutic modalities, due to late clinical presentation and lack of consensus regarding treatment. We report a 71-year old man who presented with syncope with incidental finding of large hepatocellular cancer with IVC thrombosis. Following extensive workup, the patient was ineligible for surgical intervention and was referred for chemoembolization with possible immunotherapy. This case highlights vigilance for occult malignant processes in patients that may present atypically.

Keywords

hepatocellular carcinoma, inferior vena cava thrombus, syncope, hepatitis, trans-arterial chemoembolization

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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