A Case of Hepatocellular Carcinoma with Tumor Thrombus in the Inferior Vena Cava with Long-Term Survival with Treatment with Nucleoside Analogues after Radical Surgery

Abstract

The prognosis of hepatocellular carcinoma (HCC) with inferior vena cava tumor thrombus (IVCTT) is very poor due to a high incidence of postoperative recurrence. We report the case of a patient with HCC with IVCTT who has survived for 14 years with radical surgical resection and postoperative antiviral therapy with nucleoside analogues (NUCs). A 47-year-old man with hepatitis B virus infection was referred to our hospital for fever of unknown origin. Using serial imaging studies, he was diagnosed with HCC of 12 cm in the right liver with a tumor thrombus extending via the right hepatic vein into the IVC. The stage was T3N0M0 (General Rules for the Clinical and Pathological Study of Primary Liver Cancer, 6th edition). Right hepatectomy and removal of the IVCTT combined with the IVC wall was performed. NUC therapy has been administered from 3 months after surgery. At present, 14 years after the surgery, the patient remains HBV-DNA negative and there has been no sign of recurrence.