Cancer in hepatic vein
Lung cancer is one of the most common and aggressive cancers.
The most important risk factor is smoking. Case report.
In high-risk patients, HCC screening protocols can lead to an earlier detection and at a treatable stage of the disease. Keywords Multiparametric Magnetic Resonance Imaging, diagnosis, hepatocellular carcinoma Rezumat Carcinomul hepatocelular CHC este cea mai frecventă tumoră malignă primară a ficatului, asociată frecvent cu ciroza, cu o incidenţă crescândă la nivel mondial. Protocoalele cancer in hepatic vein screening al CHC la pacienţii cu risc crescut pot duce la detectarea mai precoce şi într-un cancer in hepatic vein tratabil al bolii. Patients with haemochromatosis are at increased risk for HCC; obesity and diabetes associated with non-alcoholic steatohepatitis are other factors that may be associated with HCC 1. Imaging, in particular Multiparametric Magnetic Resonance Imaging MP MRI represents a key element in the diagnostic algorithm and in the multidisciplinary customized management of each patient, allowing the number and size of tumoral nodules, their semiology, the involvement of intra- and extrahepatic vascular structures portal venous structures — PV, hepatic veins — HV, inferior vena cava — IVCthe presence extrahepatic spread, the existence of anatomical variants or other incidentally discovered lesions
A year-old male, with a history of smoking for 30 years, presented for dyspnea at mild effort, right upper quadrant pain and right hemiplegia installed progressively 2 weeks before admission. Clinical examination revealed: cachectic cancer de colon hemorroides decreased breath sounds, without crackles, normal blood pressure and heart rate, pain in the right hypochondrium, hepatomegaly ] with nodular irregularities, right quasi-complete hemiplegia.
Lab tests: leukocytosis with neutrophilia, thrombocytosis, mild hepatic cytolysis, increased inflammatory markers. CT scan revealed multiple brain tumors, with discrete perilesional edema, some with necrosis, with thick, irregular, nodular appearance; two tumors in the left lung. Secondary pulmonary, hepatic and cerebral determinations.
Right portal vein thrombosis. Neurosurgical exam cancer in hepatic vein that the patient had no surgical indication.
At bronchoscopy, no lesions have been detected, therefore no biopsy could be performed. The patient was referred to the oncologist for palliative treatment. The final diagnosis was: left pulmonary tumor with hepatic and cerebral pulmonary determinations, total right portal vein thrombosis, right quasi-complete hemiplegia.
Sometimes, the clinical onset of cancer is related to the symptoms of metastasis.
A late diagnosis limits the therapeutical options only to palliative therapy. The particularity of the case consists of clinical onset with neurological signs cancer in hepatic vein to cerebral metastasis. Keywords: lung cancer, portal vein thrombosis, cerebral metastases, hemiplegia.