OnCo
termsTerm

Portal vein tumour thrombus (macrovascular invasion)

aka portal vein, portal vein invasion, macrovascular invasion, tumour thrombus, vascular invasion, portal hypertension

Liver cancer growing into the main vein that brings blood from the gut to the liver. It marks advanced disease, rules out most surgery and transplant, and makes some local treatments unsafe.

Hepatocellular carcinoma has a propensity to invade the portal and hepatic veins; macrovascular invasion defines BCLC stage C, excludes transplantation and usually resection, and makes TACE hazardous because the liver would lose both blood supplies, so radioembolisation, radiotherapy to the thrombus or systemic therapy (atezolizumab-bevacizumab) are used. Portal hypertension from cirrhosis, separately, causes varices and ascites and limits treatment options. Renal cell carcinoma can similarly extend into the renal vein and inferior vena cava, which is removed with the kidney.

Category
Anatomy

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