Budd-Chiari syndrome secondary to intracardiac extension of hepatocellularcarcinoma. Two cases treated by radical resection

Two young women presenting Budd-Chiari syndrome as the primary manifestatio n of hepatocellular carcinoma with intracardiac extension were treated by d ebulking of the atrium and inferior vena cava under extracorporeal circulat ion and major hepatectomy. The first patient who was treated in a single pr ocedure died during the immediate postoperative period. The second patient who was treated in two steps died of meningeal and pulmonary metastases 12 months later. Clinical findings and surgical strategy for this rare conditi on are discussed in the light of 6 previously reported surgical cases.