Abstract
Hepatocellular carcinoma usually metastasizes to regional lymph nodes, lung, and bones but can rarely invade the inferior vena cava with intravascular extension to the right atrium. We present the case of a 75-year-old man who was admitted for generalized oedema and was found to have advanced HCC with invasion of the inferior vena cava and endovascular extension to the right atrium. In contrast to the great majority of hepatocellular carcinoma, which usually develops on the basis of liver cirrhosis due to identifiable risk factors, none of those factors were present in our patient.
Highlights
Primary hepatocellular carcinoma (HCC) is a quite uncommon tumor in North America and Western Europe but is the fifth most common cancer worldwide and the third leading cause of cancer-related death [1, 2]
Most cases of HCC occur in patients with chronic liver disease or preexisting liver cirrhosis
We present the rare case of an advanced hepatocellular carcinoma with invasion of the inferior vena cava and intravascular extension to the right atrium in a patient without any preexisting liver disease
Summary
Primary hepatocellular carcinoma (HCC) is a quite uncommon tumor in North America and Western Europe but is the fifth most common cancer worldwide and the third leading cause of cancer-related death [1, 2]. Most cases of HCC occur in patients with chronic liver disease or preexisting liver cirrhosis. Common causes for liver cirrhosis are chronic alcoholic liver disease or chronic viral hepatitis due to hepatitis B virus or hepatitis C virus infection [2]. It usually metastasizes to regional lymph nodes, lung, or bone but sometimes shows invasion of major blood vessels with endovascular extension [8, 9]. We present the rare case of an advanced hepatocellular carcinoma with invasion of the inferior vena cava and intravascular extension to the right atrium in a patient without any preexisting liver disease
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