Key result
Transthoracic echocardiography performed for suspected acute coronary syndrome incidentally detected an inferior vena cava mass, leading to the diagnosis of hepatocellular carcinoma with vascular invasion.
Why the study?
Hepatocellular carcinoma may invade vascular structures such as the inferior vena cava in advanced stages, but its detection during cardiac imaging is uncommon.
Case Report (n=1)
This case highlights the importance of systematic echocardiographic evaluation, including subcostal views, which can incidentally detect significant extracardiac pathology such as hepatocellular carcinoma.
Hepatocellular carcinoma is a primary liver malignancy that may invade vascular structures, including the inferior vena cava, in advanced stages. Detection during cardiac imaging is uncommon. A 73-year-old man with hypertension and type 2 diabetes mellitus presented with chest pain suggestive of acute coronary syndrome. Initial electrocardiographic assessment and cardiac biomarkers showed no evidence of myocardial injury. During transthoracic echocardiographic evaluation, an unexpected mass was identified within the inferior vena cava on the subcostal view. Subsequent contrast-enhanced computed tomography demonstrated a large right hepatic lobe mass with characteristic arterial enhancement and portal venous/delayed-phase washout, along with inferior vena cava invasion. Histopathological examination confirmed hepatocellular carcinoma. This case illustrates the importance of a systematic echocardiographic approach, as incidental extracardiac findings may reveal significant underlying disease and alter clinical management.
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Alharbi et al. (2026) conducted a case report in Hepatocellular carcinoma and Acute Coronary Syndrome (n=1). Transthoracic echocardiography was evaluated on Incidental detection of inferior vena cava mass and hepatocellular carcinoma. Transthoracic echocardiography performed for suspected acute coronary syndrome incidentally detected an inferior vena cava mass, leading to the diagnosis of hepatocellular carcinoma with vascular invasion.
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