Surgical treatment for recurrent hepatocellular carcinoma with tumor thrombi in right atrium: Using cardiopulmonary bypass and deep hypothermic circulatory arrest

Tumor in the right atrium creates a life-threatening condition and should b e removed immediately. A cirrhotic patient who had recurrent hepatocellular carcinoma (HCC) over remnant liver with tumor thrombi extending to inferio r vena cava (IVC) and right atrium presented with impending congestive hear t failure. The recurrent tumor and its thrombi were successfully resected e n-bloc using cardiopulmonary bypass and hypothermic circulatory arrest. Alt hough the patient's disease-free and actual survival time were only 6 month s and 14 months, respectively, he was rescued from heart failure. This aggr essive surgical strategy creates further possibility to treat such advanced HCC cases. Further investigations regarding adjuvant therapies in these ci rcumstances, however, are necessary. J. Surg. Oncol. 2000;74:227-231. (C) 2 000 Wiley-Liss, Inc.