Summary
A case of primary liver carcinoma with intracavitary cardiac extension is presented. A 36-year-old female was admitted to our surgical clinic with dyspnea and generalized edema. Echocardiography and superior vena cavography demonstrated a large filling defect in the right atrium. After a diagnosis of acute cardiac failure due to an intracardiac tumor, the patient was operated upon immediately. A right atriotomy exposed a large yellow mass within the right atrium, which was not adherent to the atrial wall. The mass was in continuity with similar material in the inferior vena cava and right hepatic vein. With a suspicion of hepatic malignancy, the atrial tumor was removed, and debulking of the mass in the inferior vena cava and right hepatic vein was performed. A postoperative histological examination of the tumor showed hepatocellular carcinoma. Her postoperative course was uneventful, and she was discharged from the hospital.
Intracardiac extension of hepatoma is rarely encountered. In this clinical setting, long-term survival cannot be anticipated from any surgery, but palliative clearing of the atrium and inferior vena cava may be of value in preventing cardiac arrest causing sudden death.
Similar content being viewed by others
References
Gustafson EG (1937) An analysis of 62 cases of primary carcinoma of the liver based on 24,400 necropsies at Bellevue Hospital. Ann Intern Med 11: 889–900
Anselmi G, Süarez JA, Machado I (1970) Wilms' tumor propagated through the inferior vena cava into the right heart cavities. Br Heart J 32: 575–578
Gregory R (1939) Primary carcinoma of the liver. Arch Intern Med 64: 566–578
McCullough DL, Gittes RF (1974) Vena cava resection for renal cell carcinoma. J Urol 112: 162
Skinner DG, Prister RF, Colvin R (1972) Extension of renal cell carcinoma into the vena cava: The rationale for aggressive surgical management. J Urol 107: 711–716
Utley JR, Mobin-Uddin K, Segnitz RH, Belin RP, Utley JF (1973) Acute obstruction of tricuspid valve by Wilms' tumor. J Thorac Cardiovasc Surg 66: 626–628
Lam CR, Webb D, Green E (1966) Primary liver tumor presenting as right atrial tumor: A case report. Surgery 59: 872–877
Ehrich DA, Widmann JJ, Berger RL, Abelmann WH (1975) Intracavitary cardiac extension of hepatoma. Ann Thorac Surg 19: 206–211
Hill JD, Hetzer R (1978) Surgery of tumors of the subdiaphragmatic inferior vena cava. J Thorac Cardiovasc Surg 76: 38–42
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Goto, H., Kaneko, Y., Utoh, J. et al. Surgery of hepatoma with intracavitary cardiac extension. Heart Vessels 2, 60–62 (1986). https://doi.org/10.1007/BF02060248
Issue Date:
DOI: https://doi.org/10.1007/BF02060248