Imaging of tumoral venous thrombosis in hepatocellular carcinoma – the essentials

Abstract

Purpose. Our objectives are to analyze the prevalence of venous thrombosis (portal vein, hepatic veins, and inferior vena cava) in hepatocellular carcinoma (HCC) in correlation with the tumoral type (nodular, mul­ti­cen­tric or infiltrative), tumoral markers and chronic liver disease etiology. Mate­rials and method. We con­duc­ted a retrospective study that included all the pa­tients admitted in the Fundeni Cli­ni­cal Institute with the diagnosis of HCC who had ima­ging studies, within a three-year interval (2018-2020), out of which we se­lec­ted cases in which HCC associated tu­mo­ral ve­nous thrombosis (723 patients), analyzing tu­mo­ral as­pects and their vascular implications. Results. The pa­tients with infiltrative type of HCC had the strongest as­so­cia­tion with tumoral venous thrombus (72.72% of cases). Malignant invasion of the portal vein was detected in 17.24% of our patients. Hepatic veins are less commonly invaded by HCC, and the tumoral thrombosis was found in 6.89% of the studied cases. Conclusions. Tumoral throm­bosis is one of the most common complications of ad­van­ced HCC, occurring most often in the portal vein, and more rarely in the hepatic veins, with extension into the inferior vena cava and the right atrium.