She lost 6 kg, experienced pain in her right lower abdomen, and upon examination, was diagnosed with liver cancer.
For two months, Mr. Thuan lost 6 kg despite not actively trying to lose weight, and his appetite decreased. Thinking these changes were due to age, he didn't see a doctor. Later, he began experiencing a dull ache in his right lower rib area. The pain persisted and gradually worsened, even after taking painkillers at home.
When the pain became severe, his family took him to Tam Anh General Hospital in Ho Chi Minh City (formerly Tan Son Hoa ward - Tan Binh district) for emergency treatment.
"The patient was admitted with severe pain in the right lower rib area, extreme fatigue, rapidly increasing pain that did not respond to painkillers. Prior to admission, there was unexplained weight loss and a history of chronic hepatitis B that had not been monitored or treated," said Dr. Phan Tuan Trong, Specialist Level I, Emergency Department.
Doctors immediately performed a bedside ultrasound, discovering a very large mass occupying almost the entire right lobe of the liver. The mass had a thick, heterogeneous structure with vascular signals inside, and was compressing the hepatic veins and branches of the portal vein.
A CT scan of the abdomen using a 1,975-slice system further revealed a tumor measuring approximately 20 x 18 x 18 cm, occupying a large portion of the right lobe of the liver.
Doctor Phan Tuan Trong examines a patient. Photo: Provided by the hospital.
A 20 cm liver tumor with a large area of hemorrhage.
On CT scan, the tumor showed strong, heterogeneous enhancement in the arterial phase, followed by a relative decrease in enhancement in subsequent phases and a capsule-like appearance. In a patient with chronic hepatitis B, these imaging features strongly suggest hepatocellular carcinoma (HCC).
Notably, the tumor contained a large area of hemorrhage. The mass protruded beyond the liver margin, compressing adjacent vascular structures. The CT scan also revealed a small amount of fluid around the liver.
Doctors held an urgent consultation between the Emergency Department, the Gastroenterology Department, and the Endovascular Intervention Unit. Given the large tumor, the bleeding, and the involvement of multiple blood vessels, the immediate priority was controlling the bleeding source and stabilizing the patient.
According to Dr. Nguyen Trung Duc, Specialist Level I, Endovascular Intervention Unit, Center for Diagnostic Imaging and Interventional Radiology, HCC is the most common type of primary liver cancer. Chronic hepatitis B is one of the important risk factors for the disease.
Prolonged viral infections can cause inflammation, liver damage, and increase the risk of developing cancer. In high-risk individuals, failure to undergo regular check-ups and monitoring may result in liver damage or cancer going undetected at an early stage.
Selective embolization for bleeding control.
"With a tumor nearly 20 cm in size, the challenge was not only to control bleeding but also to minimize damage to the remaining healthy liver tissue. If embolization is performed over a wide area, especially in patients with underlying liver disease, liver function may be impaired after the intervention. Therefore, we prioritized selectively accessing the bleeding vessel to control hemorrhage while preserving as much of the remaining functioning liver tissue as possible," Dr. Duc explained.
The patient was taken to the digital subtraction angiography (DSA) room. From the right femoral artery, the doctor inserted a catheter system to the hepatic artery to examine the branches supplying blood to the tumor.
DSA imaging showed the tumor receiving blood from multiple arterial branches. At one of the branches supplying the tumor, the doctor observed contrast extravasation, indicating active bleeding.
The doctor inserts a selective microcatheter deep into the bleeding vessel, reaching the bleeding site and then performing embolization. This approach helps to focus the effect on the target area while minimizing impact on the arterial branches supplying blood to the healthy liver tissue.
Post-procedure DSA imaging no longer showed contrast extravasation at the bleeding site, indicating that the source of bleeding had been controlled.
According to Dr. Duc, embolization in this situation is primarily aimed at controlling bleeding. After the emergency situation stabilizes, the patient still needs a comprehensive assessment of liver function, tumor spread, and overall condition to determine the stage of the disease and choose the next treatment strategy.
Early-stage liver cancer often progresses silently.
After approximately 90 minutes of intervention, Mr. Thuan was transferred to the Anesthesia and Resuscitation Department for further monitoring. One day later, the pain in his right lower rib area significantly decreased, the patient ate and drank better, and was able to walk and perform personal activities.
Once his condition stabilized, he was discharged from the hospital and continued follow-up appointments and treatment as planned by his doctor.
According to Dr. Duc, early-stage liver cancer often progresses silently. Patients may have no symptoms or only vague symptoms such as fatigue, poor appetite, and weight loss. As the tumor grows larger, patients may experience pain in the right lower rib area, bloating, and rapid weight loss. If the tumor bleeds or ruptures, the pain may appear suddenly and intensely.
People with chronic hepatitis B need regular check-ups so their doctor can assess viral activity, the extent of liver damage, and the risk of liver cancer. For those in the HCC surveillance group, regular screenings increase the chances of detecting tumors early, leading to more treatment options.
Source: https://giadinh.suckhoedoisong.vn/nguoi-dan-ong-69-tuoi-phat-hien-khoi-ung-thu-gan-20-cm-ben-trong-xuat-huyet-tu-dau-hieu-de-bi-bo-qua-172261003063926535.htm
