Abstract
Budd-Chiari syndrome (BCS), caused by venous outflow obstruction, results in hepatic congestion and portal hypertension. BCS is also associated with a relatively high incidence of hepatocellular carcinoma (HCC). Selecting a minimally invasive approach based on hemodynamic assessment for the management of HCC arising from BCS is essential. A hepatic tumor located in liver segment 8 region was identified in an 88-year-old female patient with BCS. Following a detailed preoperative hemodynamic evaluation using angiography, a thoracoscopic transthoracic hepatectomy (TTH) was successfully performed. TTH may represent a feasible and effective surgical option for HCC in high-risk patients, including those with BCS.