Cardiac Metastases from Hepatocelluar Carcinoma-Can It be Identified Early?

A number of diseases may cause right a trial mass. Primary cardiac tumors range from0.002 to 0.25%. Intra cardiac manifestation and pulmonary embolism of hepato cellular carcinoma (HCC) is a very rare finding and uncommon even at autopsy. Here we describe the case of a 32-year-old Asian man who was referred for shortness of breath lasting for a month, along with unproductive cough. He was a manual laborer with a history of diabetes, alcoholism, and smoking. Clinically he was diagnosed as having pulmonaryembolism. Echocardiogram showed a mass in the right atrium. Magnetic resonance imaging showed that he had a large mass in the right atrium extending down into the inferior vena cava. Further evaluation showed that he had chronic liver disease with portal hypertension and was hepatitis B surface antigen-positive, indicating hepatitis B infection. He underwent excision of the mass, and the pathological report showed metastasis of HCC with multiple vascular emboli in the lungs. As this is the second reported case of this kind in the literature, we highlight the need of screening at least6-monthly all patients with chronic liver disease, hepatitis B and C virus infection for the early detection of HCC.

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