title: Left atrial metastasis from hepatocellular carcinoma with liver cirrhosis.
abstract: Surgical treatment in hepatocellular carcinoma patients with cardiac involvement is challenging, and its prognosis remains unclear because of its rarity. A 48-year-old male hepatocellular carcinoma patient presented with right atrial involvement through the inferior vena cava and a left atrial mass, which nearly occluded the mitral valve, and extended from a pulmonary metastasis. Emergent surgery was performed due to sudden severe respiratory failure despite profound liver cirrhosis (Child-Pugh class B). Nevertheless, the patients postoperative course was uneventful, and over six months of follow-up, he has shown no remarkable symptoms and has maintained a tolerable liver function.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Seoul National University, Borame Medical Center, and Seoul National University Hospital, 39, Boramae Road, DongJak-Gu, Seoul 156-707, South Korea. cabg333@paran.com
authors.forename: Dong Seop
authors.initials: DS
authors.lastname: Jeong
authors.forename: Jun
authors.initials: J
authors.lastname: Sung Kim
authors.forename: Kyung-Hwan
authors.initials: KH
authors.lastname: Kim
authors.forename: Hyuk
authors.initials: H
authors.lastname: Ahn
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000503:physiopathology / Q000556:secondary* / Q000601:surgery; D006348:Cardiac Surgical Procedures; D017024:Chemotherapy, Adjuvant; D006325:Heart Atria / Q000473:pathology; D006338:Heart Neoplasms / Q000503:physiopathology / Q000556:secondary* / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000503:physiopathology; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D008175:Lung Neoplasms / Q000503:physiopathology / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013510:Pulmonary Surgical Procedures; D012131:Respiratory Insufficiency / Q000209:etiology; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000473:pathology