Cheng C Y, Chien S T, Chen T Y, Chen K S, Wong F N, Lin C K, Lin C S
Department of Internal Medicine, Chung Shan Medical and Dental College Hospital, Taichung, Taiwan, Republic of China.
Gaoxiong Yi Xue Ke Xue Za Zhi. 1995 Sep;11(9):528-36.
Hepatocellular carcinoma (HCC) is one of the most common neoplasma in Taiwan. The tumor itself has the tendency of extension into the venous system, such as to the portal vein, hepatic vein and inferior vena cava (IVC), but intra-atrial metastasis is unusual. Antemortem diagnosis was difficult before the availability of two-dimensional echocardiography (2-DE). Sometimes, the first symptoms and signs are cardiogenic manifestations such as dyspnea on exertion, syncope, edema of the lower legs, and shock. Clinicians may mistakenly make the wrong diagnosis of heart failure. Because of this, we hereby report three cases of HCC with right intra-atrial metastasis to raise the physician's awareness. All three cases initially presented as right side heart failure. Imaging study revealed hepatocellular carcinoma with right intra-atrial metastasis. Two of the three cases died within one month after diagnosis.
肝细胞癌（HCC）是台湾地区最常见的肿瘤之一。肿瘤本身有向静脉系统蔓延的倾向，如门静脉、肝静脉和下腔静脉（IVC），但心房内转移并不常见。在二维超声心动图（2-DE）出现之前，生前诊断很困难。有时，首发症状和体征是心源性表现，如劳力性呼吸困难、晕厥、下肢水肿和休克。临床医生可能会误诊为心力衰竭。因此，我们特此报告3例伴有右心房转移的HCC病例，以提高医生的认识。所有3例最初均表现为右侧心力衰竭。影像学检查显示肝细胞癌伴右心房转移。3例中有2例在诊断后1个月内死亡。
