Hepatocellular carcinoma tumor thrombus resulting in Budd Chiari and right atrial invasion

Case contributed by Michael P Hartung
Diagnosis almost certain

Presentation

Shortness of breath.

Patient Data

Age: 70 years
Gender: Male

Cirrhosis and ascites. Hepatic venous and IVC occlusion by vascular tumor thrombus extending into and filling the right atrium. Tumor thrombus extends inferiorly into the sub hepatic IVC. 

Small segmental and subsegemental acute pulmonary emboli. 

Case Discussion

Dramatic case of HCC tumor thrombus filling and obstructing the hepatic veins, IVC, and invading into the right atrium. The obvious vascularity and heterogeneous enhancement confirms that it is tumor thrombus, and not bland thrombus.

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