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Migration of Hepatocellular Carcinoma Into the Right Atrium
Emaad Siddiqui1, Pallavi Solanki1, Christine Gerula1
1Division of Cardiology, Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Insights
Hepatocellular carcinoma, a liver cancer, can invade major blood vessels like the inferior vena cava and right atrium. This advanced case highlights the aggressive nature and widespread metastasis of this liver disease.
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.
Abstract:
A 40-year-old man with a medical history of hepatitis B presented with abdominal distention and leg swelling. A computed tomography scan of the abdomen revealed cirrhosis and a large mass extending from the liver into the inferior vena cava and extending into the right atrium. A transthoracic echocardiogram revealed a large right atrial mass extending from the inferior vena cava with possible attachment to the interatrial septum. The patient was eventually determined to have advanced hepatocellular carcinoma with invasion into the inferior vena cava and into the right atrium, along with pulmonary metastases.
