Background : Hepatocellular carcinoma (HCC) is one of the most common malignant tumours and the second leading cause of cancer-related deaths [1]. Further-more, tumor thrombus (TT) formation in the portal or hepatic vein is common in the advanced stages of HCC [2]. Furthermore, the treatment options at this stage are limited and not very effective. We report the case of a patient with HCC associated with a tumor thrombus extending into the IVC that was treated with open surgery left hepatectomy by extended sternotomy.

Methods : A 78-year-old man, who had been hepatitis C virus (HCV) positive for around 20 years, was diagnosed with primary HCC and cirrhosis. He had received no treatment for HCC before admission to our hospital. Pre-operative computed tomography (CT) revealed a large tumor in the left hepatic lobe, along with a tumor thrombus extending from the accessory hepatic vein through the inferior vena cava (IVC).

Results : Surgery involved left hepatectomy for tumor removal and sternotomy to address the tumor thrombus in the IVC. The procedure concluded without complications.

Conclusions : When the tumor thrombus invades the inferior venacava (IVC) and right atrium (RA), the prognosis is usually very poor, since the condition may lead to cardiacfailure or pulmonary embolization. Furthermore, it is crucial to conduct further studies on different cases to ensure that the efficacy of surgical treatments for each specific case is maximized.