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Resection of Metastatic Hepatocellular Carcinoma in the Ventricular Septum Causing Left Ventricular Outflow Tract

W Hampton Gray1, Rhusheet Patel1, Craig J Baker1

  • 1Division of Cardiothoracic Surgery, CardioVascular Thoracic Institute, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.

The Annals of Thoracic Surgery
|February 20, 2018
PubMed

Insights

Isolated cardiac metastasis from hepatocellular carcinoma (HCC) is rare. This case report details successful surgical relief of left ventricular outflow tract (LVOT) obstruction caused by recurrent HCC in the interventricular septum (IVS).

Area of Science:

  • Cardiology
  • Oncology
  • Surgical Oncology

Background:

  • Recurrent metastatic hepatocellular carcinoma (HCC) rarely involves the heart.
  • Left ventricular outflow tract (LVOT) obstruction is a critical complication.

Observation:

  • A patient presented with LVOT obstruction.
  • The obstruction was caused by isolated recurrent HCC infiltrating the interventricular septum (IVS).

Findings:

  • Surgical resection of the cardiac tumor via ventriculotomy was performed.
  • Interventricular septum (IVS) reconstruction with a patch repair successfully relieved the LVOT obstruction.
  • The patient experienced symptom relief and was discharged within 6 days.

Implications:

  • This case highlights the possibility of isolated cardiac metastasis in recurrent HCC.
  • Surgical intervention can effectively manage LVOT obstruction caused by cardiac tumors.
  • Early diagnosis and surgical management are crucial for improving outcomes in rare cardiac metastases.

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