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Right atrial mass associated with hepatoma--2 case reports
Insights
Hepatocellular carcinoma rarely spreads to the heart. Echocardiography aids in diagnosing right atrial tumor thrombi, a life-threatening complication of hepatoma, enabling timely intervention.
Area of Science:
- Cardiology
- Oncology
- Medical Imaging
Background:
- Hepatocellular carcinoma (HCC) commonly metastasizes via the venous system.
- Intracardiac extension of HCC into the right atrium is rare but poses a significant risk of sudden death due to potential blood flow obstruction.
Observation:
- This study presents two cases of HCC with intracardiac tumor thrombi extending into the right atrium.
- Diagnosis of these right atrial tumor thrombi was challenging in the past but is now readily achieved using echocardiography.
Findings:
- Two-dimensional echocardiography effectively detected right atrial tumor thrombi in both presented cases of hepatocellular carcinoma.
- Successful surgical removal of such tumor thrombi has been reported, offering a potential treatment avenue.
Implications:
- Echocardiography is crucial for diagnosing cardiac metastasis in hepatoma patients presenting with cardiac symptoms.
- Early detection via echocardiography can guide timely surgical intervention for right atrial tumor thrombi, improving patient outcomes.
Abstract:
Hepatoma has a tendency to spread into the venous system, but intracavitary cardiac extension or metastasis of hepatocellular carcinoma is an uncommon form of cardiac malignancy. When the carcinoma grows from the hepatic vein into the right atrium, the right atrial tumor thrombis may hinder the blood flow. Therefore, these patients have the risk of sudden death. In the past, antemortem diagnosis of right atrial tumor thrombi in patients with primary hepatocellular carcinoma was difficult. But, echocardiography allowed easy detection of the intracardiac tumor thrombi. We describe two cases of hepatocellular carcinoma with right atrial tumor thrombi. In these cases, the right atrial tumor thrombi was detected by two-dimensional echocardiography. Recently, successful surgical removal of the right atrial tumor thrombi are reported in several cases. We advocate performing echocardiographic examination in patients with hepatoma who have cardiac symptoms and signs.