• Yuanjun Liu, Kunlin Xie, Jiaxin Li, Zhi Wang, Yong Zeng, and Hong Wu.
• Department of Liver Surgery & Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy.
• Medicine (Baltimore). 2021 May 28; 100 (21): e26081e26081.

RationaleHepatocellular carcinoma (HCC) with inferior vena cava tumor thrombus (IVCTT) is traditionally considered an advanced-stage cancer with a poor prognosis. There is no standard treatment for patients diagnosed as HCC with IVCTT.Patient ConcernsA 52-year-old man was admitted to our hospital because of suspected hepatic mass during a health examination.DiagnosesComputed tomography (CT) showed a hepatic mass approximately 4.3 cm × 6.3 cm in size located in segment VII of the liver, with thrombus in the inferior vena cava. The mass exhibited a pattern of early enhancement and washout on contrast-enhanced CT. Alpha-fetoprotein was 614.1 ng/mL (normal value, <8 ng/mL). The preoperative diagnosis was HCC with IVCTT.InterventionsTwo months after stereotactic body radiotherapy combined with sorafenib therapy, a planned open anatomical resection of the right posterior lobe of the liver was performed.OutcomesThe patient is alive without disease 12 months after surgery, and the level of alpha-fetoprotein is normal.LessonsThe patient diagnosed as HCC with IVCTT was successfully treated by stereotactic body radiotherapy combined with molecularly targeted drugs followed by surgical treatment. If confirmed in future studies, this would suggest a promising strategy for the management of HCC with IVCTT.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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