This is a case report of a 45-year-old patient admitted with the symptom of bilateral leg swelling. Ultrasonography revealed a hyperechoic mass in the right lobe of the liver, which invaded the right hepatic vein (RHV) and extended into the inferior vena cava (IVC) and right atrium (RA). Based on the high alpha-fetoprotein (AFP) level and the ultrasonography findings, the patient was diagnosed as having hepatocellular carcinoma (HCC) with a RHV, IVC, and RA tumor thrombus and secondary Budd-Chiari syndrome (BCS). HCC with a tumor thrombus extending into the IVC and RA has rarely been observed, and as a cause of secondary BCS, this type of HCC has been even more rarely reported. K E Y W O R D S hepatocellular carcinoma, inferior vena cava, right atrium, tumor thrombus S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section. Movie S1. Transthoracic echocardiography, apical 4-chamber view, revealed a thrombus (yellow arrow) in the RA. RA = right atrium; RV = right ventricle; LA = left atrium; LV = left ventricle; TT = tumor thrombus; IVC = inferior vena cava. Movie S2. Transthoracic echocardiography showed the TT in the RA coming from the IVC and the thrombus in the RHV and IVC (red arrow). RA = right atrium; RV = right ventricle; TT = tumor thrombus; IVC = inferior vena cava; RHV = right hepatic vein. Movie S3. Abdominal ultrasound showed the TT coming from the IVC (red arrow) and integrating with the liver mass (white arrow). LV = left ventricle; RV = right ventricle; TT = tumor thrombus; IVC = inferior vena cava. Movie S4. Transthoracic echocardiography showed that the tumor thrombus in the RHV, IVC (red arrow) and RA was continuous. RA = right atrium; RV = right ventricle; TT = tumor thrombus; IVC = inferior vena cava; RHV = right hepatic vein. How to cite this article: Chen M, Huang X, Yang Q. Hepatocellular carcinoma with inferior vena cava and right atrial tumor thrombus: A case report. Echocardiography.

BACKGROUND As shown in the statistics from the World Health Organization, it is estimated that approximately 75000 new cases of cervical cancer occur every year in China. In 2008, 33000 people died of cervical cancer in China. It is proven that most women are at risk of cervical cancer. The progression from human papillomavirus (HPV) infection to cervical cancer can be several years or decades, which offers a unique opportunity to prevent cancer. AIM To observe the changes in ThinPrep cytology tests (TCT) and HPV infection in patients who were detected to be positive via TCT screening of cervical cancer and further explore the biopsy results. METHODS This paper performed a follow-up study on 206 cervical cancer screening-positive patients of 12231 total cases from our previous research. We conducted an observational study on the TCT results based on the interpretation of The Bethesda System. RESULTS Over a 5-year period, 10 cases received consistent follow-up. The proportions of cases in which glandular epithelial lesions were detected increased over the follow-up period. The differences between the years were statistically significant ( P < 0.01). Over the 5 years, the proportion of patients whose squamous epithelial lesions transformed into glandular epithelial lesions increased yearly. Annual positive rates of HPV infection were: year 1, 73% (24/33); year 2, 43% (6/14); year 3, 36% (9/25); year 4, 50% (9/18); and year 5, 25% (6/24). The positive detection rate after biopsy over a 9-year period was 29%. CONCLUSION The follow-up study for 5 years to 9 years revealed a tendency to change from squamous epithelial lesions to glandular epithelial lesions and an improvement of the disease (which had not been reported previously). The HPV test indicated a high negative conversion ratio of the viral infection. However, the follow-up cases were not found to have persistent infection of high-risk HPV. Therefore, early intervention of cervical cancer screening is necessary. Low re-examination compliance, patient education, and preventive measures should be enhanced.

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This paper focused on the question about whether situation models are embodied in human cognition. The embodied cognition theory could be a potential solution to the grounding problem in cognitive psychology. However, when it is linked to the situation model theory, it became ambiguous about whether the situation models are also embodied. According to the situation model theory, people could simulate things that are implied or not stated in the text as well, but the current evidence for embodied cognition only showed that people would reenact mental simulation while they read a word explicitly. This paper would begin with a review about the embodied cognition theory and situation model theory as well as their behavioral evidence, and then the authors would suggest further way of testing the embodiment of situation models.