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Oncol."],"abstract":"<jats:p>Thromboembolic complications after microwave ablation of colorectal liver metastases are rare but can be life-threatening. We report a 43-year-old woman with advanced colon adenocarcinoma and a synchronous right hepatic lobe metastasis who underwent laparoscopic right hemicolectomy combined with microwave ablation. Sixteen days post-procedure, imaging revealed an inferior vena cava thrombus extending into the right atrium. Despite therapeutic anticoagulation with low-molecular-weight heparin and warfarin, the right atrial thrombus paradoxically increased in size. Anticoagulation alone failed, and the patient successfully underwent thoracoscopic cardiac thrombectomy. Microwave ablation of liver metastases adjacent to the inferior vena cava or its major hepatic vein can trigger thrombosis with paradoxical upward extension to the right atrium, even during therapeutic anticoagulation. When anticoagulation fails, surgical thrombectomy may be lifesaving. This case underscores the need for high clinical vigilance for thromboembolic events after microwave ablation in high-risk anatomical settings and highlights the importance of a multidisciplinary management approach.<\/jats:p>","DOI":"10.3389\/fonc.2026.1897189","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T04:23:02Z","timestamp":1786681382000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Right atrial extension of inferior vena cava thrombosis after microwave ablation of colorectal liver metastasis: a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Yun","family":"Lin","sequence":"first","affiliation":[{"name":"Fuzong Clinical Medical College of Fujian Medical University (900th Hospital of PLA Joint Logistic Support Force)","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaoling","family":"He","sequence":"additional","affiliation":[{"name":"The School of Basic Medical Sciences, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingfang","family":"Zuo","sequence":"additional","affiliation":[{"name":"Fuzong Clinical Medical College of Fujian Medical University (900th Hospital of PLA Joint Logistic Support Force)","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwei","family":"Yu","sequence":"additional","affiliation":[{"name":"Fuzong Teaching Hospital of Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yewen","family":"Wang","sequence":"additional","affiliation":[{"name":"Fuzong Teaching Hospital of Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Zheng","sequence":"additional","affiliation":[{"name":"Fuzong Clinical Medical College of Fujian Medical University (900th Hospital of PLA Joint Logistic Support Force)","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruixiang","family":"Zhou","sequence":"additional","affiliation":[{"name":"The School of Basic Medical Sciences, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Fuzong Clinical Medical College of Fujian Medical University (900th Hospital of PLA Joint Logistic Support Force)","place":["Fuzhou, China"]},{"name":"Fuzong Teaching Hospital of Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Yang","sequence":"additional","affiliation":[{"name":"Fuzong Clinical Medical College of Fujian Medical University (900th Hospital of PLA Joint Logistic Support Force)","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s12959-023-00481-8","article-title":"Thrombus formation in the suprahepatic inferior vena cava after microwave ablation in patients with hepatic metastasis: a case report","volume":"21","author":"Ma","year":"2023","journal-title":"Thromb J"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.21037\/qims-21-1043","article-title":"Computed tomography-guided microwave ablation for non-small cell lung cancer patients on antithrombotic therapy: a retrospective cohort study","volume":"12","author":"Xu","year":"2022","journal-title":"Quant Imaging Med Surg"},{"key":"B3","unstructured":"Colon Cancer (Version 2.2026). 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