Related Experiment Video
Updated: Aug 5, 2026
Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
Right atrial invasion by metastatic esophageal adenocarcinoma with direct connection to liver
Ali Zohair Nomani1, Kaleem Ullah Toori1
1Department of Medicine, KRL Hospital, Islamabad.
Insights
Metastatic esophageal adenocarcinoma can extend directly into the heart. This rare presentation involves tumor thrombus spreading from the liver to the right atrium via the inferior vena cava.
Area of Science:
- Cardiology
- Oncology
- Gastroenterology
Background:
- Right atrial masses typically arise from primary cardiac tumors, thrombus, or metastatic disease.
- Gastrointestinal tumors rarely invade the atria, with esophageal cancers being particularly uncommon causes.
Observation:
- This case presents a rare instance of metastatic esophageal adenocarcinoma.
- The tumor demonstrated direct extension, forming a tumor thrombus that spread from the liver into the right atrium through the inferior vena cava.
Findings:
- Esophageal tumors, lacking a serosal layer, exhibit early spread to sites including the liver, lungs, and mediastinum.
- The direct hepatic-to-atrial tumor thrombus via the inferior vena cava is a unique pathway of metastatic spread.
Implications:
- This case highlights an unusual route of metastasis for esophageal adenocarcinoma.
- Understanding such rare presentations is crucial for accurate diagnosis and management of advanced cancers.
Abstract:
Common causes of right sided intra-cardiac atrial masses include primary cardiac tumors (atrial myxoma), atrial thrombus, tumor thrombus with hepatocellular or other thoracoabdominal cancers and metastatic lesions. Invasion of atria by gastrointestinal tumors is rare and that with esophageal ones seldom observed. Esophageal cancers rather present with dysphagia, odynophagia or systemic symptoms. Due to the lack of a serosal layer, esophageal tumors usually spread early in their course. Typical sites of spread include liver, gut, mediastinum, lungs and draining lymph nodes. We report a case of metastatic esophageal adenocarcinoma presenting with direct extension of metastatic tumor thrombus from liver to right atrium via inferior vena cava.
