Right Sided Heart Mass Reveals Hepatocellular Carcinoma

Abstract

© S Z ency department because of inguinal pain. After manual eduction of the long-standing inguinal hernia, ankle dema, thrombocytopenia and elevated liver enzymes ere noticed. Abdominal echography discovered a mass nto the inferior vena cava and the subsequent transthoacic echocardiographic study showed a huge right atrial ass (95 mm × 42 mm) extending in the right ventricle, bstructing the tricuspid valve orifice, with caudal extenion into the inferior vena cava (Fig. 1A). Urgent surgical excision of the cardiac mass was perormed through a standard median sternotomy and via a tochemistry confirms hepatic origin of the mass staining tumoral cells with Hepatocyte Antigen (DAKO, OCH1E5) (Fig. 1C). Moreover the CT-scan confirmed the presence of an under-dome liver lesion of 40 mm with hypervascular shell and cystic core (Fig. 1D). Diagnosis of HCC was made and transarterial chemoembolization was scheduled three months after surgery. A second liver chemoembolisation was necessary eight months after surgery and oral chemotherapy with Sorafenib-Tosilato was started. After 19 months follow-up, he leads a normal life without cardiac reoccurrence.