Migration of Hepatocellular Carcinoma Into the Right Atrium

Area of Science:

• Hepatobiliary Medicine
• Cardiovascular Oncology
• Medical Imaging

Background:

• Hepatocellular carcinoma (HCC) is a primary liver cancer often diagnosed late.
• Hepatitis B infection is a significant risk factor for HCC development.
• Vascular invasion is a known complication of advanced liver cancer.

Purpose of the Study:

• To report a rare case of advanced hepatocellular carcinoma with extensive vascular invasion.
• To illustrate the diagnostic challenges and imaging findings in such cases.
• To highlight the importance of comprehensive staging in liver cancer management.

Main Methods:

• Case report of a 40-year-old male patient.
• Diagnostic imaging including computed tomography (CT) scan of the abdomen.
• Transthoracic echocardiogram (TTE) for cardiac assessment.

Main Results:

• CT revealed liver cirrhosis and a large mass invading the inferior vena cava (IVC) and right atrium.
• Echocardiogram confirmed a large right atrial mass extending from the IVC.
• Diagnosis of advanced HCC with IVC and right atrial invasion, and pulmonary metastases was established.

Conclusions:

• Advanced hepatocellular carcinoma can present with extensive tumor burden and vascular invasion.
• Multimodality imaging is crucial for accurate diagnosis and staging of complex HCC cases.
• Invasion into the inferior vena cava and right atrium signifies a critical stage of liver cancer progression.