[A case of hepatocellular carcinoma (HCC) with a huge tumor thrombus in the right atrium]
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Hepatocellular carcinoma (HCC) can spread to the heart, forming a large tumor thrombus in the right atrium. This rare case highlights the importance of advanced imaging in diagnosing advanced liver cancer with cardiac involvement.
Area of Science:
- Oncology
- Cardiology
- Radiology
Background:
- Hepatocellular carcinoma (HCC) is a primary liver malignancy.
- Tumor thrombus formation, especially extending into the heart, is a rare but serious complication of HCC.
- Early and accurate diagnosis is crucial for patient management.
Observation:
- A patient presented with imaging findings suggestive of a large mass within the liver.
- Advanced imaging, including CT, angiography, and scintigraphy, revealed a significant tumor burden in the liver and an unusual defect in the right atrium.
- Specific tests like inferior vena cavography and gallium-67 citrate scintigraphy were key in identifying the cardiac involvement.
Findings:
- Computed tomography (CT) and celiac angiography confirmed hepatocellular carcinoma (HCC) within the liver.
- Inferior vena cavography and cardiac blood pool scintigraphy identified a large defect in the right atrium, indicative of a tumor thrombus.
- Abnormal uptake on 67Ga-citrate scintigraphy further supported the presence of neoplastic tissue in the right atrium.
Implications:
- This case underscores the potential for HCC to metastasize via tumor thrombus into the right atrium.
- Accurate diagnosis relies on a combination of cross-sectional imaging and nuclear medicine techniques.
- Autopsy confirmation validated the clinical diagnosis, emphasizing the aggressive nature of this presentation.
Abstract:
A case of HCC with a huge tumor thrombus in the right atrium is reported. CT and celiac angiography revealed HCC in the liver. Inferior vena cavography and cardiac blood pool scintigraphy demonstrated a large defect in the right atrium, and 67Ga-citrate scintigraphy showed a lesion of abnormal accumulation in the right atrium. With these findings, diagnosis of HCC with a tumor thrombus in the right atrium was made, and the clinical diagnosis was confirmed by autopsy.