Korean Circ J.  2011 Sep;41(9):542-545. 10.4070/kcj.2011.41.9.542.

A Case of Left Atrial Metastasis From Hepatocellular Carcinoma: Life-Saving Palliative Resection Using Cardiopulmonary Bypass

• Seo JB
• Kim JS
• Jeong DS
• Chung WY
• Kim SH
• Kim MA
• Zo JH

• KMID: 2094107
• DOI: http://doi.org/10.4070/kcj.2011.41.9.542

Abstract

Hepatocellular carcinoma (HCC) with metastasis to the heart is uncommon. We report a rare case of left atrial metastasis of HCC which was resected palliatively as a live-saving procedure with the use of cardiopulmonary bypass. Despite chemoembolization, which was undertaken 11 times, cardiac metastasis occurred. Moreover, the right and left atria and left ventricle were involved simultaneously. The severe dyspnea improved dramatically after surgery. Following this, the patient underwent systemic chemotherapy and lived a life without recurrence of symptoms associated with mitral valve obstruction.

Keyword

Carcinoma, hepatocellular; Neoplasm, metastasis; Heart; Surgery

MeSH Terms

Carcinoma, Hepatocellular
Cardiopulmonary Bypass
Dyspnea
Heart
Heart Ventricles
Humans
Mitral Valve
Neoplasm Metastasis
Recurrence

Figure

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  Fig. 1 Tumor thrombi within right hepatic vein, inferior vena cava (A) and right atrium (B) demonstated by CT scan 3 months before surgical resection.

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  Fig. 2 Persistent tumor thrombi within right hepatic vein, inferior vena cava (A) and right atrium (B) demonstated by CT scan just days before surgical resection.

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  Fig. 3 Echocardiogrphic images at systole (A) and diastole (B). Left atrium thrombus obstructing the mitral valve shown in image B.

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  Fig. 4 Tumor thrombus extracted during surgery.

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  Fig. 5 Echocardiogrphic images demonstrated no left atrial mass after surgery.

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