| Discovery of an inta-atrial extension of hepatocellular carcinoma in a patient presenting with right-heart failure |
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Ji-Hyun Kim, Mi-Jung Kim, Jee-Hyun An, Yongjun Cha, Hoonsung Choi, Hyosang Kim, Hyung-Kwan Kim |
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| 우심부전으로 발현된 간세포암의 우심방 전이 1예 |
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김지현, 김미정, 안지현, 차용준, 최훈성, 김효상, 김형관 |
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| Abstract |
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A primary right atrial (RA) mass is not common; instead, most tumors in the right atrium originate from metastasis through the caval route. Here we describe a patient with a huge RA tumor that showed contiguous spread from the inferior vena cava. This 60-year-old patient, positive for hepatitis B surface antigen, visited the emergency department of our institution due to recently aggravated dyspnea. Transthoracic and transesophageal echocardiography clearly demonstrated a huge RA mass, 6.5×6.0 cm, causing flow disturbance. Cardiac magnetic resonance imaging and dynamic computed tomography of the liver showed multiple large hepatic masses that extended into the right atrium, with tumor thrombi in the inferior vena cava. Given the enhancement pattern in dynamic computed tomography of the liver, the hepatic mass was diagnosed as hepatocellular carcinoma. Due to the risk of spontaneous rupture of the mass, emergency transarterial chemoembolization was performed, without complications. Thereafter, thalidomide, which has been shown to have anti-angiogenic effects, was prescribed to the patient. |
| Key Words:
Mass, Cardiac; Carcinoma, Hepatocellular; Echocardiography; Magnetic resonance imaging; Computed tomography |
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