Isolated Intracardiac Metastasis: The First Sign of Hepatocellular Carcinoma

Metastatic hepatocellular carcinoma (HCC) to the right atrium without invasion of the inferior vena cava is a very rare and difficult diagnosis, especially when the primary tumour is yet to be known. A 68-year-old man with symptoms of heart failure was admitted to the emergency department; his trans...

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Autores principales:	Anusca Paixão, Rita Silva, Natália Lopes, Sónia Carvalho, Paulo Carrola, José Presa Ramos
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	acute heart failure isolated cardiac metastasis hepatocellular carcinoma Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/fb32f91974c24382a76b091a7dba6dcb
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spelling	oai:doaj.org-article:fb32f91974c24382a76b091a7dba6dcb2021-11-18T11:08:47ZIsolated Intracardiac Metastasis: The First Sign of Hepatocellular Carcinoma2341-45452387-195410.1159/000519545https://doaj.org/article/fb32f91974c24382a76b091a7dba6dcb2021-10-01T00:00:00Zhttps://www.karger.com/Article/FullText/519545https://doaj.org/toc/2341-4545https://doaj.org/toc/2387-1954Metastatic hepatocellular carcinoma (HCC) to the right atrium without invasion of the inferior vena cava is a very rare and difficult diagnosis, especially when the primary tumour is yet to be known. A 68-year-old man with symptoms of heart failure was admitted to the emergency department; his transthoracic echocardiogram showed a mass comprehending almost the totality of the right atrium, obliterating its entrance nearly completely and impeding the normal auricular–ventricular flux, described as a possible auricular myxoma. The patient was promptly transferred to cardiothoracic surgery and submitted to an urgent surgery to completely remove the mass, which was macroscopically described as suspected of malignancy. Further investigation demonstrated a single nodule in the liver with malignant imaging characteristics, and the histology confirmed the diagnosis of metastatic HCC of the right atrium, without metastatic disease elsewhere. He was then submitted to radiofrequency ablation and medicated with sorafenib. The disease progressed slowly but subsequently involved the inferior vena cava and portal vein, culminating in his death 4 years and 3 months after the diagnosis. Although the prognosis for metastatic HCC may be poor, especially with intracavitary heart metastasis, this case shows that an aggressive initial approach with surgical metastasectomy may prolong the median survival of the patients.Anusca PaixãoRita SilvaNatália LopesSónia CarvalhoPaulo CarrolaJosé Presa RamosKarger Publishersarticleacute heart failureisolated cardiac metastasishepatocellular carcinomaDiseases of the digestive system. GastroenterologyRC799-869ENGE: Portuguese Journal of Gastroenterology, Pp 1-4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute heart failure isolated cardiac metastasis hepatocellular carcinoma Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	acute heart failure isolated cardiac metastasis hepatocellular carcinoma Diseases of the digestive system. Gastroenterology RC799-869 Anusca Paixão Rita Silva Natália Lopes Sónia Carvalho Paulo Carrola José Presa Ramos Isolated Intracardiac Metastasis: The First Sign of Hepatocellular Carcinoma
description	Metastatic hepatocellular carcinoma (HCC) to the right atrium without invasion of the inferior vena cava is a very rare and difficult diagnosis, especially when the primary tumour is yet to be known. A 68-year-old man with symptoms of heart failure was admitted to the emergency department; his transthoracic echocardiogram showed a mass comprehending almost the totality of the right atrium, obliterating its entrance nearly completely and impeding the normal auricular–ventricular flux, described as a possible auricular myxoma. The patient was promptly transferred to cardiothoracic surgery and submitted to an urgent surgery to completely remove the mass, which was macroscopically described as suspected of malignancy. Further investigation demonstrated a single nodule in the liver with malignant imaging characteristics, and the histology confirmed the diagnosis of metastatic HCC of the right atrium, without metastatic disease elsewhere. He was then submitted to radiofrequency ablation and medicated with sorafenib. The disease progressed slowly but subsequently involved the inferior vena cava and portal vein, culminating in his death 4 years and 3 months after the diagnosis. Although the prognosis for metastatic HCC may be poor, especially with intracavitary heart metastasis, this case shows that an aggressive initial approach with surgical metastasectomy may prolong the median survival of the patients.
format	article
author	Anusca Paixão Rita Silva Natália Lopes Sónia Carvalho Paulo Carrola José Presa Ramos
author_facet	Anusca Paixão Rita Silva Natália Lopes Sónia Carvalho Paulo Carrola José Presa Ramos
author_sort	Anusca Paixão
title	Isolated Intracardiac Metastasis: The First Sign of Hepatocellular Carcinoma
title_short	Isolated Intracardiac Metastasis: The First Sign of Hepatocellular Carcinoma
title_full	Isolated Intracardiac Metastasis: The First Sign of Hepatocellular Carcinoma
title_fullStr	Isolated Intracardiac Metastasis: The First Sign of Hepatocellular Carcinoma
title_full_unstemmed	Isolated Intracardiac Metastasis: The First Sign of Hepatocellular Carcinoma
title_sort	isolated intracardiac metastasis: the first sign of hepatocellular carcinoma
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/fb32f91974c24382a76b091a7dba6dcb
work_keys_str_mv	AT anuscapaixao isolatedintracardiacmetastasisthefirstsignofhepatocellularcarcinoma AT ritasilva isolatedintracardiacmetastasisthefirstsignofhepatocellularcarcinoma AT natalialopes isolatedintracardiacmetastasisthefirstsignofhepatocellularcarcinoma AT soniacarvalho isolatedintracardiacmetastasisthefirstsignofhepatocellularcarcinoma AT paulocarrola isolatedintracardiacmetastasisthefirstsignofhepatocellularcarcinoma AT josepresaramos isolatedintracardiacmetastasisthefirstsignofhepatocellularcarcinoma
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Isolated Intracardiac Metastasis: The First Sign of Hepatocellular Carcinoma

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