1/ This was one of the most tragic, toughest cases we had to manage
This middle aged man came with abdominal discomfort and was found to have a large tumor inside the liver that had spread into the veins inside the liver (hepatic veins) and also into the large vein that drains..
This middle aged man came with abdominal discomfort and was found to have a large tumor inside the liver that had spread into the veins inside the liver (hepatic veins) and also into the large vein that drains..
2/..into the heart (called IVC or inferior vena cava).
Without a biopsy diagnosis of the type of cancer, oncology/radiotherapy would not proceed with treatment plans
The bleeding tests were abnormal and there was mild fluid in abdomen of this patient - this meant that we..
Without a biopsy diagnosis of the type of cancer, oncology/radiotherapy would not proceed with treatment plans
The bleeding tests were abnormal and there was mild fluid in abdomen of this patient - this meant that we..
3/..could not perform a direct biopsy of the tumor in the liver due to high risk of bleeding
Without a biopsy diagnosis, we could not proceed with treatment plans
So @SRajesh_IR, our lead Interventional Radiologist, does something adventurous. The family wanted a diagnosis..
Without a biopsy diagnosis, we could not proceed with treatment plans
So @SRajesh_IR, our lead Interventional Radiologist, does something adventurous. The family wanted a diagnosis..
4/..to at least understand what was hurting the patient.
Dr Rajesh approaches the cancer filled clots in the large vein through a catheter placed through another vein in the leg and fires the biopsy gun through the middle of the tumor filled vein
A risky procedure, that could..
Dr Rajesh approaches the cancer filled clots in the large vein through a catheter placed through another vein in the leg and fires the biopsy gun through the middle of the tumor filled vein
A risky procedure, that could..
5/..tear the large blood vessel that could instantly kill the patient or dislodge the tumor into the heart - but with precision and skill, clots were retrieved for pathologist to review
& it showed hepatocellular carcinoma, a primary cancer of liver arising from liver cells..
& it showed hepatocellular carcinoma, a primary cancer of liver arising from liver cells..
6/..that was clogging the big vein and swarming the heart chambers.
There was NO CIRRHOSIS - that is the liver was not permanently scarred and there was no chronic liver disease
Usually liver cancers arise in cirrhosis liver
But in adults there are three main..
There was NO CIRRHOSIS - that is the liver was not permanently scarred and there was no chronic liver disease
Usually liver cancers arise in cirrhosis liver
But in adults there are three main..
7/..conditions of the liver, where liver cancer can form even in the ABSENCE of cirrhosis, that is in a healthy looking liver
a] Hepatitis B and C virus
and most importantly
b] Non-alcoholic fatty liver disease without cirrhosis
Yes, a condition called NASH - that is when..
a] Hepatitis B and C virus
and most importantly
b] Non-alcoholic fatty liver disease without cirrhosis
Yes, a condition called NASH - that is when..
8/..there is fat in liver + inflammation + fibrosis (without cirrhosis), can increase risk of developing liver cancer or HCC in absence of cirrhosis
This patient had severe untreated fatty liver disease and developed an aggressive liver tumor that spread to his heart.
This patient had severe untreated fatty liver disease and developed an aggressive liver tumor that spread to his heart.
9/ Every person who has high risk of NASH must check themselves at least ONCE, if not ever done before
Diabetes
Obesity
Mild-moderate alcohol/tobacco
Heart disease/high lipids
Family history of cirrhosis, liver cancer
or combinations of these
Our patient is on end-of-life care
Diabetes
Obesity
Mild-moderate alcohol/tobacco
Heart disease/high lipids
Family history of cirrhosis, liver cancer
or combinations of these
Our patient is on end-of-life care
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