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Left atrial metastasis from hepatocellular carcinoma with liver cirrhosis

Dong Seop Jeong1, Jun Sung Kim, Kyung-Hwan Kim

  • 1Department of Thoracic and Cardiovascular Surgery, Seoul National University, Borame Medical Center, and Seoul National University Hospital, 39, Boramae Road, DongJak-Gu, Seoul 156-707, South Korea. cabg333@paran.com

Interactive Cardiovascular and Thoracic Surgery
|August 26, 2010
PubMed

Insights

Surgical intervention for hepatocellular carcinoma with cardiac invasion is complex. This case demonstrates a successful emergent surgery for a patient with extensive tumor involvement, showing good short-term outcomes.

Area of Science:

  • Hepatobiliary surgery
  • Cardiovascular surgery
  • Oncology

Background:

  • Hepatocellular carcinoma (HCC) rarely involves the heart, making surgical treatment challenging and prognosis uncertain.
  • Cardiac involvement in HCC can occur via the inferior vena cava (IVC) or pulmonary veins, posing significant surgical risks.

Observation:

  • A 48-year-old male with liver cirrhosis (Child-Pugh class B) presented with advanced HCC.
  • The patient exhibited right atrial involvement via the IVC and a left atrial mass nearly occluding the mitral valve, originating from a pulmonary metastasis.
  • Sudden severe respiratory failure necessitated emergent surgical intervention.

Findings:

  • The emergent surgery for extensive cardiac and pulmonary metastasis from HCC was successfully performed.
  • The patient experienced an uneventful postoperative course.
  • Over six months of follow-up, the patient remained asymptomatic with stable liver function.

Implications:

  • This case highlights the feasibility of aggressive surgical management in selected HCC patients with cardiac involvement.
  • Successful surgical resection may offer a viable treatment option, improving outcomes in this rare and challenging presentation.
  • Further research is warranted to establish standardized surgical protocols and long-term survival data for HCC with cardiac invasion.

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