Inferior vena cava thrombus

Abstract

Summary Background: The inferior vena cava (IVC) thrombus is an entity with many different causes and clinical presentations. Methods: In the past five years, we treated 16 patients with IVC thrombus and a diagnosis of primary hepatic carcinoma in 6 (37.5%), metastatic hepatic carcinoma in 8 (50%), and Budd-Chiari syndrome in 2 patients (12.5%). Results: Conservative treatment with enhanced immunotherapy, chemotherapy, and transcatheter arterial chemoembolization for the hepatic malignancies led to an overall survial of 82.2% at 16-month follow-up. Discussion: The prognosis of IVC tumor thrombus is usually poor and the surgical techniques are quite challenging. Surgical re-section combined with chemotherapy for advanced hepatocellular carcinoma with tumor thrombus has led to promising results. Aggressive radical nephrectomy with IVC thrombectomy remains the most effective therapeutic option in patients with renal cell carcinoma and IVC tumor thrombus. With the development of minimally invasive surgical techniques and the avoidance of cardiopulmonary bypass, less trauma and prolonged survival can be expected for IVC thrombus of malignant etiology.