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Updated: Jul 25, 2025

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
A Rare Type of Hepatocellular Carcinoma Presenting With Cardiac Thrombus
Majd B Aboona1, Wendi Zhou2, Karn Wijarnpreecha3,4
1Internal Medicine, Department of Medicine, University of Arizona College of Medicine - Phoenix, Phoenix, USA.
Insights
Hepatocellular carcinoma (HCC) rarely causes right atrial thrombus. Early cancer screening in compensated cirrhosis is crucial to prevent rare, advanced liver cancer complications.
Area of Science:
- Hepatology
- Cardiology
- Oncology
Background:
- Hepatocellular carcinoma (HCC) is a common complication of end-stage liver disease.
- Right atrial tumor thrombus is a rare manifestation of HCC.
- Nonalcoholic fatty liver disease (NAFLD) is a leading cause of cirrhosis.
Abstract:
Hepatocellular carcinoma (HCC) is a complication of end stage liver disease. Even rarer is right atrial tumor thrombus burden due to HCC. Common metastatic sites of HCC in descending order are lung, peritoneum, and bone. We present a patient with liver cirrhosis due to nonalcoholic fatty liver disease (NAFLD) admitted due to incidental finding of right atrial thrombus on echocardiography after missing HCC surveillance for four years. Patient received a computed tomography (CT) scan that showed an inconclusive liver lesion despite two liver biopsies, and patient was incidentally found to have clear cell HCC diagnosed after right hepatectomy. Right atrial thrombus was treated with surgical thrombectomy and pathology showed necrotic HCC thrombi in right atrium with bile pigment. Due to the possibility of tumor growth with extrahepatic manifestations, screening in compensated cirrhosis is essential.
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