Isolated Right Ventricle Metastasis of Hepatocellular Carcinoma—A Case Report—

Abstract

A 68-year-old man underwent-left-hemihepatectomy for a 17-cm-sized hepatocellular carcinoma in the medial segment. Then, 1 year and 4 months after the first operation, he visited a local doctor with dyspnea, and a 3-cm-diameter tumor was found in the right ventricle that was suspected to be metastasis from hepatocellular carcinoma. Because he had symptoms of cardiac failure that could cause sudden death, he underwent tumor excision and tricuspid valve replacement. He was discharged from the hospital 15 days after surgery with an uneventful course. The excised tumor was confirmed to be metastasis from hepatocellular carcinoma. Multiple recurrences were observed in the lumbar spine, lung, and cardiophrenic angle 3 months after the second surgery. He was treated with the molecular target agent sorafenib. However, it was discontinued due to side effects such as interstitial pneumonia. Since then, he has received palliative treatment. He is still alive without cardiac failure 1 year and 1 month after the second surgery. If patients have symptoms of cardiac failure after liver resection for hepatocellular carcinoma, the possibility of cardiac metastasis should be considered. There is no established standard therapy for isolated metastasis of hepatocellular carcinoma in the ventricle.