Transabdominal Intrapericardial Approach in Liver Transplantation for Unresectable Primary Hepatic Functioning Paraganglioma With Invasion Into Hepatic Veins and Suprahepatic Vena Cava: A Surgical and Anesthesia Management Challenge
| Autor: | John P. Scott, Stacee M. Lerret, Nghia N. Vo, Joohyun Kim, Johnny C. Hong, Paula E. North, Roger A. Fons, Grzegorz Telega, Bernadette Vitola, Meghen B. Browning, Calvin M. Eriksen, Michael A. Zimmerman, George M. Hoffman |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Vena cava Orthotopic liver transplantation medicine.medical_treatment Locally advanced Hepatic Veins Liver transplantation Paraganglioma medicine Humans Neoplasm Invasiveness Critical location Transplantation business.industry Abdominal Wall Liver Neoplasms medicine.disease Liver Transplantation Surgery Hepatic veins cardiovascular system Venae Cavae Approaches of management business Pericardium |
| Zdroj: | Transplantation Proceedings. 50:2630-2635 |
| ISSN: | 0041-1345 |
| Popis: | Primary hepatic functional paraganglioma is a rare form of extra-adrenal catecholamine-secreting tumor. Definitive treatment of functioning paraganglioma is challenging because of the critical location of the tumor frequently in close proximity to vital structures and risk of excessive catecholamine release during operative manipulation. We report the multidisciplinary management approach for a case of unresectable primary hepatic functional paraganglioma with invasion into the hepatic veins and suprahepatic vena cava. To our knowledge, this is the first report showing that orthotopic liver transplantation is curative for patients with unresectable primary hepatic paraganglioma. For locally advanced unresectable hepatic paraganglioma that involves the intrapericardial vena cava, a meticulous pre- and intraoperative medical management and transabdominal intrapericardial vascular control of the suprahepatic vena cava during orthotopic liver transplantation allows for complete extirpation of the tumor and achieves optimal outcome. |
| Databáze: | OpenAIRE |
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