The First Department of Pathology, Kurume University School of Medicine Hepatocellular carcinoma (HCC) accounts for approximately 80% of hepatic malignancies, and it tends to increase year by year. Despite the liver receives blood supply through both the hepatic artery and the portal vein, HCC itself and tumor thrombus of the portal vein mainly receive arterial blood supply, and the portal vein seems to play a role of an efferent vessel. Accordingly HCC tends to form tumor thrombus in the portal vein in early stage and forms abnormal shunt between the artery and the portal vein (A-P shunt). According to the introduction of transcatheter arterial embolization therapy for HCC, a long survival can be expected even in advanced cases of HCC. In long survived cases, varying degrees of organization of tumor thrombus occurs and may increase a risk of rupture of esophageal varices due to acceleration of portal hypertension.
Thus, it is predicted that management of esophageal varices in HCC will be important in future.