Surgery for Intracavitary Cardiac Extension of Hepatoma: Report of a Case

A 36-year-old female was admitted to our surgical clinic because of dyspnea and generalized edema, Echocardiography and superior vena cavography revealed a large tumor in the right atrium. With a diagnosis of acute cardiac failure due to an intracardiac tumor, the patient received an emergency opeartlon. A right atriotomy revealed a large yellow mass within the right atrium, but not adherent to the atrial wall. The mass was continuous with similar material in the inferior vena cava and the right hepatic vein. With a deagnosis of probable hepatic malignancy, the atrial tumor was removed and also debulking of the mass in the inferior vena cava and right hepatic vein was performed. Postoperative histological examination of the tumor showed hepatocellular carcinoma. The patient's post-operative course was uneventful and she was discharged from the hospital. Intracardiac extension of hepatocellular carcinoma is rarely encountered. In this clinical setting, long-term survival cannot be anticipated after any surgery, but palliative clearing of the atrium and inferior vena cava may be of value for preventing sudden cardiac death.