Intracardiac Metastasis of Hepatocellular Carcinoma: A Rare Pathologic Case Involving the Right Atrium

Document Type

Conference Proceeding

Publication Date

11-12-2025

Publication Title

Am J Clin Pathol

Keywords

vimentin, aged, atrial fibrillation, case report, clinical article, conference abstract, cytoplasm, diagnosis, dizziness, drug therapy, fatigue, heart right atrium, heart tumor, hematoma, histopathology, human, human cell, human tissue, immunofluorescence, immunohistochemistry, liver cell carcinoma, liver metastasis, male, metastasis, mitosis

Abstract

Introduction/Objective: Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and frequently metastasizes to the lungs, bones, and lymph nodes. Cardiac involvement, especially metastasis to the right atrium, is exceptionally rare and often has a poor prognosis. Methods/Case Report: A 78-year-old male with a known history of metastatic HCC and multiple cardiovascular comorbidities, including atrial fibrillation, presented with worsening dizziness and generalized fatigue. Imaging studies revealed hepatic masses, a subcapsular hematoma, and a right atrial mass. Gross examination of the biopsy material revealed friable, white rubbery tissue fragments. Microscopic evaluation demonstrated neoplastic cells arranged in pseudoglandular patterns, with enlarged nuclei, prominent nucleoli, abundant eosinophilic cytoplasm and brisk mitosis. Immunohistochemical staining showed strong positivity for HepPar-1(cytoplasmic pattern) and vimentin, consistent with hepatocellular origin. The tumor was negative for CK7 and CK20. These findings confirmed the diagnosis of metastatic hepatocellular carcinoma involving the right atrium. Results: NA Conclusion: Intracardiac metastasis of hepatocellular carcinoma is an uncommon but clinically significant finding. Histopathologic evaluation is indispensable in confirming diagnosis and guiding therapeutic strategies.

Volume

164

First Page

S131

Last Page

S132

Find It @ Sladen

Share

COinS