A case of hepatic encephalopathy in a patient with unresectable hepatocellular carcinoma and portal vein tumor thrombus successfully treated with shunt embolization and multimodal therapy

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  • Shimizu Riku
    Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University
  • Matsui Teppei
    Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University
  • Nagumo Hideki
    Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University
  • Kobayashi Kojirou
    Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University Division of Gastroenterology, Nissan Tamagawa Hospital
  • Ogino Yu
    Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University
  • Mukozu Takanori
    Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University
  • Wakui Noritaka
    Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University
  • Nagai Hidenari
    Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University

Bibliographic Information

Other Title
  • 門脈腫瘍塞栓合併肝細胞癌に伴う肝性脳症に対してシャント塞栓術を行うことにより，肝細胞癌の集学的治療が可能となった一例
  • モンミャク シュヨウ ソクセン ガッペイ カン サイボウ ガン ニ トモナウ カンセイ ノウショウ ニ タイシテ シャント ソクセンジュツ オ オコナウ コトニ ヨリ,カン サイボウ ガン ノ シュウガクテキ チリョウ ガ カノウ ト ナッタ イチレイ

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Description

<p>In September 20XX, a 50-year-old male was admitted to our hospital with leg and scrotal edema. He was later diagnosed with hepatocellular carcinoma (HCC), portal vein tumor thrombus (PVTT), and inferior vena cava thrombosis. The PVTT shrank after lenvatinib and hepatic arterial infusion chemotherapy, and a cavernous transformation was found. It was challenging to continue chemotherapy because of the refractory hepatic encephalopathy caused by a mesocaval shunt. Therefore, a coil-assisted retrograde transvenous obliteration II was performed, which improved the hepatic encephalopathy and enabled the resumption of multimodal HCC therapy. We are reporting this case as it is rare and interesting, and also examine related literature.</p>

Journal

  • Kanzo

    Kanzo 65 (2), 81-91, 2024-01-23

    The Japan Society of Hepatology

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