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Hepatocellular Carcinoma with Heart Involvement

肝細胞癌個案合併心臟侵犯

摘要


肝細胞癌合併心臟侵犯並不常見,我們報告一肝細胞癌合併右心房侵犯的58歲男性;因為臨床上沒有右心衰竭的症狀,也沒有任何血管栓塞的表現,此右心房的癌細胞侵犯是於例行的影像追蹤時發現的。由影像檢查可見,癌細胞與其伴隨的栓塞從肝臟經由下腔靜脈一路侵犯到右心房。該病患拒絕手術的介入,而接受標靶藥物(Sorafenib)以及後續的臨床試驗;然而整個病程持續惡化,病患於診斷後8個月死亡。我們進一步回顧文獻中關於肝細胞癌合併心臟侵犯的臨床表現、治療以及預後;總而言之,肝細胞癌合併心臟侵犯的病患預後極差。

並列摘要


Hepatocellular carcinoma (HCC) with heart involvement is uncommon. Herein, we report a 58-year-old male with advanced HCC and right atrium involvement. The patient's HCC was detected accidentally by routine image follow-up because he lacked typical signs of right heart failure and had not suffered any thromboembolic event. Review of the patient's image study revealed that the tumor, with associated thrombus, extended from the liver through the inferior vena cava into the right atrium. He refused surgical intervention, received self-paid Sorafenib and then underwent 3 cycles of clinical trial. He finally died of progressive disease 8 months after diagnosis. Following review of the literature regarding the clinical features, management, and outcomes of HCC with heart involvement, we concluded that HCC with heart involvement strongly portends a poor prognosis.

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