Marzouka George R, Badheka Apurva, Rodriguez Alexis P, Chaparro Sandra V
Division of Cardiology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Clinical Research Building, Room 1107, Miami, FL 33136, USA.
Department of Internal Medicine, University of Miami Miller School of Medicine, 1611 NW 12th Avenue, Central Building, Room 600D, Miami, FL 33136, USA.
Case Rep Cardiol. 2014;2014:192737. doi: 10.1155/2014/192737. Epub 2014 Nov 30.
Hepatocellular carcinoma (HCC) is the sixth most prevalent cancer in the world, but metastatic disease to the heart is rare. We present a case of a 63-year-old man with history of hepatitis C and cirrhosis, which had progressed to HCC. The patient had undergone two prior liver transplantations. He presented to the hospital complaining of worsening lower extremity edema. His exam was also pertinent for jugular venous distension, a 3/6 crescendo-decrescendo murmur, and hepatosplenomegaly. A transthoracic echocardiogram showed a large irregular lobulated mass in the apex of the right ventricle with a mobile pedunculated component. An MRI of the heart revealed a 4.4 × 3.4 × 4.0 cm mass within the right ventricular apex, which was subsequently biopsied and found to be moderately differentiated HCC with myocardial fragments. The patient opted out of any further therapy, or intervention, and was enrolled in hospice care.
肝细胞癌（HCC）是全球第六大常见癌症，但心脏转移疾病却很罕见。我们报告一例63岁男性病例，该患者有丙型肝炎和肝硬化病史，已进展为HCC。患者此前接受过两次肝移植。他因下肢水肿加重前来医院就诊。体格检查还发现颈静脉怒张、3/6级递增递减型杂音以及肝脾肿大。经胸超声心动图显示右心室心尖部有一个大的不规则分叶状肿块，伴有一个可移动的带蒂成分。心脏MRI显示右心室心尖部有一个4.4×3.4×4.0厘米的肿块，随后进行活检，发现为中度分化的HCC并伴有心肌碎片。患者选择不接受任何进一步治疗或干预，并接受临终关怀。
