G: Male, Age 52. Requesting any advice, suggestions. Doctors have suggested Radiation Therapy for now.

Diagnosis: Hepatitis B related Chronic liver disease with decompensation jaundice ascites hepatocellular carcinoma with total vein tumour thrombus 

Child-Pugh score 10, Child Class C, MELD na-27

Course in the Hospital. Me XYZ was admitted in the ward, his treatment was further optimised, USG abdomen showed gross ascites with portal radical thrombus, after obtaining informed consent, he underwent USG guided acitic tapping on 18/02/22 and 3.5 ltr acitic fluid was drained. PET CT was done on 18th Feb which was suggestive of Hepatocellular carcinoma with large FDG avid Thrombus in main portal vein extended to its right and left branches and to there segmental branches.

Future Treatment Plan:  Radiation oncology opinion was sought and further management and plan was discussed. 

Investigation: Liver is enlarged in size(span is 176 mm) and shows altered heterogeneous echotexture with irregular outline. No Focal parenchymal lesion is seen. Hepatic veins and portalvenous radicals are normal. IHBR not dilated. Portal vein shows no obvious colour flow on doppler imaging.