TY - JOUR
T1 - Hémorragie intra-tumorale massive responsable d'un syndrome cave
T2 - Une complication rare d'un carcinome hépato-cellulaire
AU - Ettorre, Giuseppe Maria
AU - Douard, Richard
AU - Santoro, Roberto
AU - Vidiri, Antonello
AU - Vennarecci, Giovanni
AU - Carboni, Fabio
AU - Boschetto, Arianna
AU - Corazza, Valerio
AU - Maritti, Michela
AU - Antonini, Mario
AU - Santoro, Eugenio
PY - 2006/3
Y1 - 2006/3
N2 - Intralesional massive haemorrhage responsible for inferior vena cava syndrome is a very rare complication of hepatocellular carcinoma. A 36-year-old man with no past medical history was referred to hospital for abdominal pain with clinical and biological signs of internal bleeding. An abdominal CT scan showed a huge right liver mass, with regular margins and a fluid content, indicating a large intratumoral haemorrhage complicating hepatocellular carcinoma. Due to haemodynamic stability and the signs of inferior vena cava compression conservative management was chosen prior to surgical treatment of the tumour. Three months later, the huge liver mass remained unchanged but the inferior vena cava syndrome had decreased and the patient's condition improved. After evaluation of liver function and the extent of the tumour, a surgical procedure was performed via a subcostal incision with midline extension and sternotomy to control the intrapericardial inferior vena cava and perform a veno-venous bypass with the technique used for orthotopic liver transplantation. Then, right hepatectomy (segments V to VIII) was performed with an anterior approach. The postoperative course was uneventful. This two-step strategy allowed successful surgery for this rare complication of a hepatocellular carcinoma on a normal liver and could be recommended for the management of any unruptured intratumoral haemorrhages.
AB - Intralesional massive haemorrhage responsible for inferior vena cava syndrome is a very rare complication of hepatocellular carcinoma. A 36-year-old man with no past medical history was referred to hospital for abdominal pain with clinical and biological signs of internal bleeding. An abdominal CT scan showed a huge right liver mass, with regular margins and a fluid content, indicating a large intratumoral haemorrhage complicating hepatocellular carcinoma. Due to haemodynamic stability and the signs of inferior vena cava compression conservative management was chosen prior to surgical treatment of the tumour. Three months later, the huge liver mass remained unchanged but the inferior vena cava syndrome had decreased and the patient's condition improved. After evaluation of liver function and the extent of the tumour, a surgical procedure was performed via a subcostal incision with midline extension and sternotomy to control the intrapericardial inferior vena cava and perform a veno-venous bypass with the technique used for orthotopic liver transplantation. Then, right hepatectomy (segments V to VIII) was performed with an anterior approach. The postoperative course was uneventful. This two-step strategy allowed successful surgery for this rare complication of a hepatocellular carcinoma on a normal liver and could be recommended for the management of any unruptured intratumoral haemorrhages.
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U2 - 10.1016/S0399-8320(06)73207-9
DO - 10.1016/S0399-8320(06)73207-9
M3 - Articolo
C2 - 16633318
AN - SCOPUS:33745785448
VL - 30
SP - 476
EP - 479
JO - Clinics and Research in Hepatology and Gastroenterology
JF - Clinics and Research in Hepatology and Gastroenterology
SN - 2210-7401
IS - 3
ER -