The presence of thrombus within the inferior vena cava (IVC) is often a sign of advance hepatocellular carcinoma (HCC). Various treatment methods have been described with variable and inconclusive results. Now, the advancement of endovascular approach offers new possibility as a potential treatment modality. We discuss the removal of tumour thrombus with catheter directed mechanical thrombectomy. IVC tumour secondary HCC was removed by AngioJet® rheolytic system (Possis Medical, Minneapolis, MN, USA) with good result. Further work should be encouraged to explore the prospect of this technique with other treatment modalities.
We report a 39-year-old male with accidental findings of posterior mediastinum mass at right superior aspects, located at T2 with close proximity to trachea, superior vena cava, azygus vein, right subclavian artery and oesophagus. Apart from intermittent right shoulder pain, there was no other significant symptom. He opted for conservative management initially, given the benign nature and proximity to important structures. We postulated that robotic approach will be of advantage for this particular case which was successfully performed with uneventful recovery. This case illustrated the advantages of robotic-assisted surgery, compared to conventional VATS in otherwise potentially difficult case to undertake.