Echocardiographic detection of a metastatic right atrial mass in a patient with previously un-diagnosed hepatocellular carcinoma who presents with dyspnea

Ber-Ren Fang, Chin-Yew Lin, I-Ping Yen

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DOI: 10.4236/health.2011.32015                

Abstract

A 69-year-old woman had experienced resistant edema of lower extremities and progressive dyspnea on exertion for two months. The pa-tient visited our emergency room owing to ex-acerbation of her dyspnea symptom. Echocar-diography demonstrated a mobile mass in the right atrium. Transesophageal echocardiogra-phy revealed a right atrial mass arising from the inferior vena cava which was partially mobile. The patient underwent urgent open heart sur-gery with resection of the right atrial mass and curettage of the tumor thrombus in the inferior vena cava. Histologic examination of the re-sected right atrial mass revealed the features of metastatic hepatocellular carcinoma. Subse-quent work-up revealed that alpha-fetoprotein level was 3780 ng/ml. Abdominal echocardi-ography showed a tumor mass in the right lobe of the liver. The post-operative course was complicated by pneumonia, sepsis, and multi- organ failure. The patient died 48 days after surgery.

Keywords

Hepatocellular Carcinoma;Right Atrial Metastasis; Echocardiography

Conflicts of Interest

The authors declare no conflicts of interest.

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