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Hepatocellular Carcinoma Masquerading as Heart Failure: When POCUS "Incidentally" Detects Cancer
Luke Shenton1, Wesley Chow1, Bruce Kimura1
1Departments of Graduate Medical Education and Cardiology, Scripps Mercy Hospital, San Diego, CA, USA.
Insights
Hepatocellular carcinoma (HCC) rarely presents as heart failure. Point-of-care ultrasound (POCUS) aided in detecting advanced liver cancer with tumor thrombus, highlighting its value in early cancer diagnosis.
Area of Science:
- Oncology
- Cardiology
- Medical Imaging
Background:
- Hepatocellular carcinoma (HCC) is a major global cause of cancer mortality.
- Cardiovascular complications can arise in advanced stages of HCC.
- Differentiating HCC from primary cardiac conditions is clinically significant.
Abstract:
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide, and cardiovascular involvement can occur in advanced cases. An 84-year-old man with subacute dyspnea on exertion and pedal edema was referred to the cardiologist for suspected heart failure. Point of care ultrasound (POCUS) revealed scant ascites, a liver mass, and inferior vena cava (IVC) tumor thrombus extending into the right atrium. Computed tomography confirmed HCC with extensive intravascular spread and pulmonary emboli. This case illustrates a rare phenomenon of HCC masquerading as heart failure and underscores the potential value and challenges of incorporating POCUS into outpatient evaluations for earlier cancer detection.
