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World J Gastroenterol. Jul 7, 2007; 13(25): 3513-3516
Published online Jul 7, 2007. doi: 10.3748/wjg.v13.i25.3513
Hepatoma with cardiac metastasis: An advanced cancer requiring advanced treatment
Yu-Sheng Lin, Shih-Ming Jung, Feng-Chun Tsai, Chun-Nan Yeh, Tzu-Fang Shiu, Hsueh-Hua Wu, Pyng-Jing Lin, Pao-Hsien Chu
Yu-Sheng Lin, Tzu-Fang Shiu, Hsueh-Hua Wu, Pao-Hsien Chu, Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan, China
Shih-Ming Jung, Department of Pathology, Chang Gung Memorial Children Hospital, Chang Gung University College of Medicine, Taipei, Taiwan, China
Feng-Chun Tsai, Pyng-Jing Lin, Division of Thoracic and Cardiovascular Surgery, Chang Gung University College of Medicine, Taipei, Taiwan, China
Chun-Nan Yeh, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan, China
Author contributions: All authors contributed equally to the work.
Supported by NHRI, Taiwan (NHRI-EX91-9108SC, NHRI-EX92-9108SC, NHRI-EX-93-9108SC, NHRI-EX94-9108SC and NHRI-EX54-9108SCl, NHRI-EX96-9627SI); CMRPG32057 from Chang Gung Memorial Hospital, and NSC Memorial Hospital; and NSC 94-2314-B-182-071 and 95-2314-B-182-021 from the National Sciences Council. Dr. Jung is supported by CMRPG33044 from Chang Gung Memorial Hospital and NSC 94-2233-B-189-999 from the National Sciences Council, Taiwan, China
Correspondence to: Pao-Hsien Chu, MD, FCCP, FACC, FESC, The First Cardiovascular Division, Department of Internal Medicine, Chang Gung Memorial Hospital, 199 Tun-Hwa North Road, Taipei 105, Taiwan, China. pchu@adm.cgmh.org.tw
Telephone: +886-3-3281200-8162 Fax: +886-3-3271192
Received: April 6, 2007
Revised: April 8, 2007
Accepted: May 12, 2007
Published online: July 7, 2007
Abstract

AIM: To investigate the clinical and pathologic findings, and to discuss the pathophysiology of hepatocellular carcinoma with cardiac metastasis.

METHODS: Eight hepatoma patients with cardiac metastasis, who were treated by surgical excision from 1993 to 2006, were retrospectively studied. Detailed clinical parameters were analyzed.

RESULTS: Of those eight patients, two (25%) were women and six (75%) were men, with the mean age of 50 years (range, 40-70 years). The presentations included: asymptomatic (75%), heart failure (25%), and pulmonary embolism (12.5%). All lesions involved the right atrium, and extended to the lung (12.5%), inferior vena cava (25%), and left atrium (12.5%). The level of tumor marker, alpha-fetal protein, was not correlated with the severity of metastasis or disease prognosis. Moreover, the availably estimated doubling time was less than 3 mo. The pathological findings included variable hemorrhage and necrosis. The survival time following surgery also varied from one month to more than 30 mo.

CONCLUSION: Hepatoma metastasis to the heart was detected in all eight patients. This study demonstrates that surgery might help the outcome in such cases.

Keywords: Hepatoma, Cardiac metastasis, Alpha-fetal protein