Hepatocellular carcinoma tumor thrombus entering the inferior vena cava treated with percutaneous RF ablation: a case report

J Ultrasound. 2019 Sep;22(3):363-370. doi: 10.1007/s40477-019-00361-w. Epub 2019 Mar 12.


Purpose: Hepatocellular carcinoma (HCC) is the most common form of liver cancer. In advanced cancer stages (metastatic disease and/or vascular invasion), the generally accepted standard of care is systemic therapy using sorafenib as first-line treatment and, recently, regorafenib and nivolumab as second-line treatment, but the quality of life and the prognosis of patients remain very poor. Our paper reports a case of US-guided radiofrequency ablation (RFA) of both intraparenchymal HCC and inferior vena cava tumor thrombus.

Methods: We treated a patient with HCC associated with tumor thrombus extending into vena cava after failure of sorafenib therapy using US-guided radiofrequency ablation (RFA).

Results: A good radiological and clinical response was observed in association with excellent tolerability. The patient has been followed up for 15 months from the ablation, is alive, and is in a good clinical condition without evidence of tumor recurrence.

Conclusion: This is the first case in which this minimally invasive percutaneous procedure has been successfully used to treat an HCC thrombus entering the vena cava.

Keywords: Hepatocellular carcinoma; Locoregional therapy; Sorafenib; Tumor thrombus; US-guided radiofrequency ablation.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Hepatocellular / secondary*
  • Carcinoma, Hepatocellular / surgery*
  • Humans
  • Liver Neoplasms / pathology*
  • Male
  • Middle Aged
  • Neoplastic Cells, Circulating*
  • Radiofrequency Ablation* / methods
  • Surgery, Computer-Assisted
  • Ultrasonography, Interventional
  • Vena Cava, Inferior*