Hepatocellular Carcinoma With Right Atrium Metastases

Abstract

Hepatocellular carcinoma is common in patients with cirrhosis regardless of the etiology. Its presentation is uncommon in patients without known cirrhosis. It can spread commonly to the lungs, abdominal lymph nodes and bone but cardiac metastases are rare. The screening and early diagnosis impact the treatment feasibility and prognosis. The most common etiologies of cirrhosis and hepatocellular carcinoma are alcohol consumption and viral hepatitis B and C, however, non-alcoholic fatty liver disease (NAFLD) is becoming a more pronounced known risk factor for steatosis, advanced liver fibrosis, cirrhosis, and thus hepatocellular carcinoma due to the rise of metabolic syndrome prevalence. Although a known risk factor, there are no current recommendations for cancer surveillance in patients with NAFLD. The aim of this paper is to raise awareness of this rising complication by describing a rare initial presentation of hepatocellular carcinoma.

A Rare Type of Hepatocellular Carcinoma Presenting With Cardiac Thrombus

“…While rare, right atrial tumor thrombus complication in cirrhosis is a possibility. In previous autopsy series the prevalence of tumor burden in the right atrium ranges from 2.4-6.3% among hepatocellular carcinoma (HCC) patients (vs. 10-40% of portal vein thrombosis in HCC) [1][2][3][4]. The median survival range of HCC with intra-cardiac involvement is one to four months [5].…”