Two Cases of Liver Tumor in which Endovascular Ultrasonography was Useful to Formulate the Operative Strategy

We preoperatively performed intracaval endovascular sonography in two cases of liver tumor adjacent to the inferior vena cava (IVC) to formulate the operative strategy. Case 1 was a 60-year-old man who was admitted to our hospital because of hepatocellular carcinoma in segment 8. As tumor invasion to the IVC was suspected, preoperative intracaval endovascular sonography was performed. The wall of the IVC was visualized as an echogenic band by sonography, so tumor invasion to the IVC was diagnosed as negative. The finding was confirmed in the operation and right lobectomy was safely performed. Case 2 was a 72-year-old man who was diagnosed with cholangiocarcinoma. As tumor invasion to the IVC was strongly suspected, preoprative intracaval endovascular sonography was performed. Part of the wall lacked respiratory movement. However, the wall was well visualized as an echogenic band, so tumor invasion was diagnosed as negative. Although inflammatory tumor adhesion to IVC was found, right lobectomy was safely performed. Intracaval endovascular ultrasonography was considered to be useful in making an accurate diagnosis of liver tumor invasion to the IVC and in formulating the operative strategy.