title: Right Atrial Mass in a Patient With HIV and Hepatitis B: A Case Report.
abstract: A 41-year-old man presented to the emergency room for evaluation of substernal chest pain, shortness of breath and generalized failure to thrive. Patient had history of hepatitis B and HIV. During recent evaluation of hepatic mass, patient was found to have hepatocellular carcinoma on biopsy. Patient had no history of cirrhosis of the liver in the past. On Echocardiogram patient was noted to have a large mass filling the right atrial cavity. CT scan of abdomen, pelvis and chest showed a diffusely enlarged heterogeneously enhancing liver consistent with large hepatoma, with portal venous and hepatic vein thrombosis. Tumor thrombus extended through the hepatic veins and upper inferior vena cava into the right atrium. There was 6 cm greatest diameter enhancing mass in the right atrium. Patient had primary hepatocellular carcinoma with extensive invasion into vascular structures. His prognosis was poor and patient opted for palliative care only. In conclusion, patients with co-infection of HIV and Hepatitis B are at risk of developing hepatocellular carcinoma with extension into the right atrium and physicians managing these patients should have high suspicion of right atrial involvement with tumor extension and low threshold to order a screening echocardiogram.
authors.affiliation: Internal Medicine, Mount Sinai Hospital-Englewood program, 151 engle st Apt A11 englewood NJ 07631, USA.
authors.forename: Muhammad Umer
authors.initials: MU
authors.lastname: Siddiqui
authors.affiliation: Interventional Cardiology, 10021 S Main St suite B-1 Houston TX 77025, USA.
authors.forename: Masroor
authors.initials: M
authors.lastname: Khan
authors.affiliation: Park Plaza Hospital Houston TX 77004, USA.
authors.forename: Timithy
authors.initials: T
authors.lastname: Anderson
keywords: Atrial Mass; Hepato-cellular carcinoma metastasis; Hepatocellular carcinoma and atrial mass