Intravariceal tumor thrombi formation in hepatocellular carcinoma. A case report.

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The formation of tumor thrombi in esophageal varices in hepatocellular carcinoma has rarely been reported. We herein report a case with such a rare complications.<BR>A 66-year-old man was admitted because of abdominal fullness and general fatigue. Ultrasonography and computed tomography disclosed a massive tumor in the right hepatic lobe and tumor thrombus in the main portal trunk. Fiberscopy disclosed esophageal varices. Angiographic examination revealed neovascularity and arterio-portal shunt in the right hepatic lobe, and subsequent visualization of esophageal varices. The patient died of intraperitoneal bleeding from the tumor. When autopsied, a massive tumor with multiple satellite lesions was evident. Compact type, moderately differentiated hepatocellular carcinoma was revealed by the microscopic examination. Tumor thrombi were found in the portal trunk and esophageal varices. Microscopically, lung metastasis was disclosed and the metastatic route from the liver via the portal vein through the esophageal varices to the lung was considered.
社団法人日本肝臓学会の論文