Surgical treatment of primary hepatocellular carcinoma with intrapericardial tumor thrombus without extracorporeal circulation

Malignant liver tumor is known for its tendency towards metastasis and vascular invasion. In patients with primary hepatocellular carcinoma (HCC), tumor thrombus (TT) in the portal vein is frequently encountered, and invasion of the hepatic vein has comparatively lower incidence (1). TT extension in the inferior vena cava (IVC) and right atrium (RA) is rarely observed and is always accompanied with tumor cell infiltration in the peripheral blood (2).