A CASE OF HEPATOCELLULAR CARCINOMA WITH METASTASES TO THE RIGHT VENTRICLE OF THE HEART

A 76-year-old man had undergone an extended right hepatectomy and a descending colectomy for synchronous double cancer, giant hepatocellular carcinoma and cancer of the descending colon in April, 1997. In the clinical findings at the operation he had multiple intrahepatic metastasis (IM3) and involvement of carcinoma cells in the portal vein (VP2). Multiple liver metastases had been well controlled by hepatic arterial infusion chemotherapy. Nine months later, he complained of being short of breath. Ultrasonic cardiography and chest computed tomography revealed massive hypertrophy of the right ventricle. We diagnosed the case as cardiac metastases of the rihght ventricular wall from hepatocellular carcinoma. For 6 months from the detection of cardic metastases to his death due to cardiac failure, the general status had been maintained by means of palliative therapy. The representative distant metastatic organs of the hepatocellular carcinoma are the lung, bone and adrenal gland. We report a rare case of hepatocellular carcinoma with cardiac metastases. This case in also interesting to consider the pathway for hepatocellular carcinoma cells reaching to the heart.