Hepatocellular Carcinoma with Intracardiac Involvement. Anthony Sung, HMS IV Gillian Lieberman, MD Beth Israel Deaconess Medical Center

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1 Hepatocellular Carcinoma with Intracardiac Involvement Anthony Sung, HMS IV Beth Israel Deaconess Medical Center

2 Case presentation Imaging Discussion Epidemiology Presentation Pathology Imaging Prognosis Case summary Outline

3 Case Presentation Paul N 71M with hepatocellular carcinoma, dx 2004 s/p bland embolization x2 and chemoembolization x2 Previous CT 2006: stable hepatoma retroperitoneal lymph nodes, IVC thrombosis Surveillance CT 2007

4 CT Hepatoma 06 vs. 07 BWH/Centricity

5 CT LN 06 vs. 07 BWH/Centricity

6 CT Adrenals 06 vs. 07 BWH/Centricity

7 CT Heart 06 vs. 07 Anthony Sung, HMS IV

8 CT Heart 07 Anthony Sung, HMS IV

9 Case Presentation Asymptomatic Exam Gen: WA, NAD VS: P 82R, BP 124/69 Abd: +HSM CV: nl S1S2, +S4, MSM at LLSB; JVP 12 cm w/prominent A waves; trace edema b/l

10 Discussion Differential Primary Tumor (<0.01%) Benign (75%) Myxoma Papillary fibroelastoma Rhabdomyoma Teratoma Lipoma Hamartoma Fibroma Malignant Angiosarcoma Rhabdomyosarcoma Fibrosarcoma Leiomyosarcoma Lymphoma Mesothelioma

11 Discussion Differential Primary Tumor (<0.01%) Benign (75%) Myxoma Papillary fibroelastoma Rhabdomyoma Teratoma Lipoma Hamartoma Fibroma Malignant Angiosarcoma Rhabdomyosarcoma Fibrosarcoma Leiomyosarcoma Lymphoma Mesothelioma Secondary Tumor (20x more common than primary; %) Isolated metastasis Lung Breast Lymphoma Leukemia Esophagus Stomach Melanoma Direct extension Kidneys Testicules Thyroid Liver

12 Discussion Differential Primary Tumor (<0.01%) Benign (75%) Myxoma Papillary fibroelastoma Rhabdomyoma Teratoma Lipoma Hamartoma Fibroma Malignant Angiosarcoma Rhabdomyosarcoma Fibrosarcoma Leiomyosarcoma Lymphoma Mesothelioma Secondary Tumor (20x more common than primary; %) Isolated metastasis Lung Breast Lymphoma Leukemia Esophagus Stomach Melanoma Direct extension Kidneys Testicules Thyroid Liver Thrombus Aneurysm Artifact

13 Discussion Differential Primary Tumor (<0.01%) Benign (75%) Myxoma Papillary fibroelastoma Rhabdomyoma Teratoma Lipoma Hamartoma Fibroma Malignant Angiosarcoma Rhabdomyosarcoma Fibrosarcoma Leiomyosarcoma Lymphoma Mesothelioma Secondary Tumor (20x more common than primary; %) Isolated metastasis Lung Breast Lymphoma Leukemia Esophagus Stomach Melanoma Direct extension Kidneys Testicules Thyroid **Liver** Thrombus Aneurysm Artifact

14 Discussion Epidemiology Hepatocellular carcinoma is the most common primary liver cancer and fifth most common cancer in the world Portal vein involvement in 26 80%; hepatic vein involvement in 11 23%; IVC involvement in %; intracardiac involvment in % Direct extension (75%), isolated metastasis (25%) Tse et al: 18 consecutive candidates for resection of HCC intracardiac involvement in 1 on TTE (6%) and 2 on TEE (11%)

15 Discussion Presentation Finding Age (average, range) % (# cases/# information available) 55, 8-83 (n=119) Gender (male) 71% (119) Symptoms (any) 91% (103/113) Right heart failure 72% (81/113) Abdominal pain or swelling 60% (62/103) Dyspnea 37% (38/103) Lower-extremity edema 63% (49/77) Tachycardia 39% (30/77) JVD 25% (19/77) Abnormal heart sounds 25% (19/77) Abnormal ECG 36% (21/58) Elevated AFP 77% (40/52)

16 Discussion Pathology Finding % (# cases/# information available) New diagnosis of HCC 63% (52/83) Satellite lesions 38% (45/119) Extrahepatic, non-cardiovascular metastases 42% (50/119) Lung metastases 35% (42/119) Lymph node metastases 8% (9/119) Pulmonary embolism 20% 924/119)

17 Discussion Imaging Angiography (1975) Echocardiography (1980) CT (1985) Nuclear medicine (1985) MRI (1990)

18 Discussion Imaging n angiography CT echocardiogram MRI nuclear % 0% 0% 0% 0% % 0% 100% 0% 0% % 23% 92% 0% 8% % 26% 84% 37% 5% % 40% 70% 0% 10% % 56% 80% 28% 0% % 50% 83% 17% 0%

19 Discussion Angiography Celiac angiography thread and streaks Vena cavography Ventriculography Dazai et al., 1989.

20 Discussion Echocardiography Simple, fast, safe, cheap, convenient Image myocardium and chambers Real time imaging with dynamic information about mobility and blood flow (using doppler) Limited views and resolution Limited by body habitus, operator TEE more sensitive; however, may be contraindicated in HCC patients with varices

21 Discussion TEE

22 Discussion CT Fast, available, high resolution Evaluate size, location, extent of disease (myocardial or intraluminal invasion) calcifications, and relationship with adjacent structures Screening, surveillance Limited planes Radiation and contrast exposure

23 Discussion MRI More expensive Discriminate between different tissues Tumor has medium signal intensity on T1 Thrombus has high signal intensity on T1 Image multiple planes Evaluate structural and anatomical relationships, mobility of mass, myocardial function, and blood flow Goldfarb et al: 20 patients with surgically confirmed vena caval tumor with thrombus extension from retroperitoneal tumors MRI identified tumor/thrombus in 100%, delineated extent in 100% CT identified tumor/thrombus in 100%, delineated extent in 33%.

24 Discussion Nuclear Radionuclide angiography [ 67 Ga] citrate [ 111 In] oxine labeled platelet scintigraphy PET Shyu et al., 1989.

25 Discussion Survival Palliative (n=12) Excision (n=38) Other (n=16) Overall (n=66) Average 3.0 months 9.1 months 10.4 months 8.3 months 1 month 75% 76% 86% 77% 6 months 17% 50% 44% 42% 12 months 0% 26% 25% 21% 24 months 0% 11% 6% 8% 48 months 0% 3% 3% 3%

26 Discussion Cause of Death Palliative (n=7) Excision (n=23) Other (n=11) Overall (n=69) Hepatic failure 85% 35% 36% 54% Cardiac failure 14% 9% 27% 17% Non-cardiac metastases 0% 35% 0% 12% Sudden death 0% 9% 18% 9% Iatrogenic 0% 9% 9% 4% Other 0% 4% 9% 4%

27 Case Presentation Imaging Angiography Echocardiography CT Nuclear medicine MRI

28 Case Presentation Imaging

29 Echo ; BWH/Centricity

30 MRI BWH/Centricity

31 MRI BWH/Centricity

32 Gross Specimen 07 BWH/OR

33 Follow up Echo 07 Echo 07 BWH/Centricity

34 Acknowledgments Joseph Loscalzo, MD Susan Cheng, MD Raul Ramirez, MD Eileen Scully, MD Nyca Bowen

35 References Anthony, P. P. (1973). "Primary carcinoma of the liver: a study of 282 cases in Ugandan Africans." J Pathol 110(1): Arai, R., T. Otsuka, et al. (2004). "Metastasis of hepatocellular carcinoma to the supramaxillary gingiva and right ventricle." Hepatogastroenterology 51(58): Atkins, K. A. (2000). "Metastatic hepatocellular carcinoma to the heart." Diagn Cytopathol 23(6): Baba, H. A., R. Engers, et al. (1995). "Right atrial metastasis as primary clinical manifestation of hepatocellular carcinoma." Int J Cardiol 47(3): Bar Sela, G., M. W. Arush, et al. (2004). "Atrial metastasis detected by two dimensional echocardiography." Acta Oncol 43(1): Barasch, E., O. H. Frazier, et al. (1994). "Left atrial metastasis from hepatocellular carcinoma: a case report." J Am Soc Echocardiogr 7(5): Barberis, V. I., S. Brili, et al. (2006). "Hepatocellular carcinoma with right atrial extension in a young patient with congenitally unguarded tricuspid orifice." Echocardiography 23(5): Butany, J., S. W. Leong, et al. (2005). "A 30 year analysis of cardiac neoplasms at autopsy." Can J Cardiol 21(8): Chan, H. S., M. J. Sonley, et al. (1985). "Primary and secondary tumors of childhood involving the heart, pericardium, and great vessels. A report of 75 cases and review of the literature." Cancer 56(4): Chang, J. Y., W. S. Ka, et al. (2004). "Hepatocellular carcinoma with intra atrial tumor thrombi. A report of three cases responsive to thalidomide treatment and literature review." Oncology 67(3 4): Chia, B. L., M. H. Choo, et al. (1985). "Two dimensional echocardiographic abnormalities of right atrial metastatic tumors in hepatoma." Chest 87(3): Chieng, S. H., C. H. Lin, et al. (2005). "Intracavitary metastatic hepatocellular carcinoma of the right ventricle." Thorac Cardiovasc Surg 53(2): Chu, M. W., A. Aboguddah, et al. (2001). "Urgent heart surgery for an atrial mass: metastatic hepatocellular carcinoma." Ann Thorac Surg 72(3):

36 References Chua, S. O., C. W. Chiang, et al. (1989). "Echocardiographic findings of mobile atrial hepatocellular carcinoma. Report of five cases." J Ultrasound Med 8(7): Chua, S. O., C. W. Chiang, et al. (1986). "Moving right atrial mass associated with hepatoma. Two cases detected by echocardiography." Chest 89(1): Culpepper, A. L. and E. von Haam (1934). "Primary carcinoma of the liver with extensive metastasis to the right heart, and tumor thrombosis of the inferior vena cava." American Journal of Cancer 21: Dazai, Y., T. Katoh, et al. (1989). "Effectiveness of chemoembolization therapy for metastatic right atrial tumor thrombus associated with hepatocellular carcinoma." Chest 96(2): Edmondson, H. A. and P. E. Steiner (1954). "Primary carcinoma of the liver: a study of 100 cases among 48,900 necropsies." Cancer 7(3): Ehrich, D. A., J. J. Widmann, et al. (1975). "Intracavitary cardiac extension of hepatoma." Ann Thorac Surg 19(2): Fujisaki, M., E. Kurihara, et al. (1991). "Hepatocellular carcinoma with tumor thrombus extending into the right atrium: report of a successful resection with the use of cardiopulmonary bypass." Surgery 109(2): Funari, M., N. Fujita, et al. (1991). "Cardiac tumors: assessment with Gd DTPA enhanced MR imaging." J Comput Assist Tomogr 15(6): Georgen, M., J. M. Regimbeau, et al. (2002). "Removal of hepatocellular carcinoma extending in the right atrium without extracorporal bypass." J Am Coll Surg 195(6): Giacalone, A., A. Suriani, et al. (1996). "Simulation of right atrial cardiac myxoma by silent hepatocellular carcinoma." Pathol Res Pract 192(12): ; discussion Goldfarb, D. A., A. C. Novick, et al. (1990). "Magnetic resonance imaging for assessment of vena caval tumor thrombi: a comparative study with venacavography and computerized tomography scanning." J Urol 144(5): ; discussion Goto, H., Y. Kaneko, et al. (1986). "Surgery of hepatoma with intracavitary cardiac extension." Heart Vessels 2(1): 60 2.

37 References Goudie, R. B. (1955). "Secondary tumours of the heart and pericardium." Br Heart J 17(2): Gregg, F. P., H. M. Goldstein, et al. (1975). "Arteriographic demonstration of intravenous tumor extension." Am J Roentgenol Radium Ther Nucl Med 123(1): Gregory, R. (1938). "Primary carcinoma of the liver." Arch Intern Med 64: Gustafson, E. G. (1937). "An analysis of 62 cases of primary carcinoma of the liver based on 24,400 necropsies at Bellevue Hospital." Ann Intern Med 11: Hahne, O. H. and A. R. Climie (1962). "Right atrial thrombi with ballvalve action." Am J Med 32: Hanfling, S. M. (1960). "Metastatic cancer to the heart. Review of the literature and report of 127 cases." Circulation 22: Hill, J. D. and R. Hetzer (1978). "Surgery of tumors of the subdiaphragmatic inferior vena cava. Report of two cases and review of the literature." J Thorac Cardiovasc Surg 76(1): Hsu, T. L., M. C. Hsiung, et al. (1992). "The value of transesophageal echocardiography in the diagnosis of cardiac metastasis." Echocardiography 9(1): 1 7. Huang, C. S., M. R. Chen, et al. (1993). "Right atrial metastasis of hepatocellular carcinoma." J Clin Ultrasound 21(5): Iemura, J., M. Aoshima, et al. (1997). "Surgery for hepatocellular carcinoma with tumor thrombus in the right atrium." Hepatogastroenterology 44(15): Imamoglu, A., H. Akalin, et al. (1989). "Hepatoma with right atrial extension." Pediatr Cardiol 10(4): Kanematsu, M., T. Imaeda, et al. (1994). "Hepatocellular carcinoma with tumor thrombus in the inferior vena cava and right atrium." Abdom Imaging 19(4): Kashima, Y., M. Miyazaki, et al. (1999). "Effective hepatic artery chemoembolization for advanced hepatocellular carcinoma with extensive tumour thrombus through the hepatic vein." J Gastroenterol Hepatol 14(9): Kato, Y., N. Tanaka, et al. (1983). "Growth of hepatocellular carcinoma into the right atrium. Report of five cases." Ann Intern Med 99(4):

38 References Klatt, E. C. and D. R. Heitz (1990). "Cardiac metastases." Cancer 65(6): Kojiro, M., H. Nakahara, et al. (1984). "Hepatocellular carcinoma with intra atrial tumor growth. A clinicopathologic study of 18 autopsy cases." Arch Pathol Lab Med 108(12): Koo, J., K. Fung, et al. (1983). "Recovery of malignant tumor cells from the right atrium during hepatic resection for hepatocellular carcinoma." Cancer 52(10): Kotani, E., K. Kiuchi, et al. (2000). "Effectiveness of transcoronary chemoembolization for metastatic right ventricular tumor derived from hepatocellular carcinoma." Chest 117(1): Kubota, H., S. Takamoto, et al. (2002). "Surgical treatment of malignant tumors of the right heart." Jpn Heart J 43(3): Lam, K. Y., P. Dickens, et al. (1993). "Tumors of the heart. A 20 year experience with a review of 12,485 consecutive autopsies." Arch Pathol Lab Med 117(10): Lazaros, G., C. Samara, et al. (2003). "Growth of hepatocellular carcinoma into the right atrium. A case of antemortem diagnosis with magnetic resonance imaging of the heart." Acta Cardiol 58(6): Lei, M. H., Y. L. Ko, et al. (1992). "Metastasis of hepatocellular carcinoma to the heart: unusual patterns in three cases with antemortem diagnosis." J Formos Med Assoc 91(4): Lin, T. Y., K. M. Chiu, et al. (2004). "Case 1. Right ventricular outflow obstruction caused by metastatic hepatocellular carcinoma." J Clin Oncol 22(6): Longo, R., D. Mocini, et al. (2004). "Unusual sites of metastatic malignancy: case 1. Cardiac metastasis in hepatocellular carcinoma." J Clin Oncol 22(24): Lothe, F. and K. Somers (1960). "Secondary tumors of the heart and pericardium in Uganda Africans." Arch Pathol 69: Lynch, M., S. D. Clements, et al. (1997). "Right sided cardiac tumors detected by transesophageal echocardiography and its usefulness in differentiating the benign from the malignant ones." Am J Cardiol 79(6):

39 References Macdonald, R. A. (1957). "Primary carcinoma of the liver; a clinicopathologic study of one hundred eight cases." AMA Arch Intern Med 99(2): Mansour, Z., S. Gerelli, et al. (2007). "Right atrial metastasis from hepatocellular carcinoma." J Card Surg 22(3): Martinez Baca Lopez, F., E. Ramirez Arias, et al. (2004). "Hepatocellular carcinoma with invasion into right cardiac cavities: report of a case and literature review." J Am Soc Echocardiogr 17(2): Masaki, N., S. Hayashi, et al. (1994). "Marked clinical improvement in patients with hepatocellular carcinoma by surgical removal of extended tumor mass in right atrium and pulmonary arteries." Cancer Chemother Pharmacol 33 Suppl: S7 11. Masci, G., M. Magagnoli, et al. (2004). "Metastasis of hepatocellular carcinoma to the heart: a case report and review of the literature." Tumori 90(3): Miller, D. L., N. M. Katz, et al. (1987). "Hepatoma presenting as a right atrial mass." Am Heart J 114(4 Pt 1): Morimoto, K., K. Matsui, et al. (1986). "Intraatrial extension of hepatocellular carcinoma detected with ultrasound." J Clin Ultrasound 14(6): Mukai, K., T. Shinkai, et al. (1988). "The incidence of secondary tumors of the heart and pericardium: a 10 year study." Jpn J Clin Oncol 18(3): Murakawa, T., S. Takamoto, et al. (2000). "Metastatic hepatocellular carcinoma obstructing the right ventricular outflow tract." Jpn J Thorac Cardiovasc Surg 48(8): Nakashima, T., K. Okuda, et al. (1983). "Pathology of hepatocellular carcinoma in Japan. 232 Consecutive cases autopsied in ten years." Cancer 51(5): Noguchi, H., K. Hirai, et al. (1994). "Small hepatocellular carcinoma with intravascular tumor growth into the right atrium." J Gastroenterol 29(1): Noguchi, M., M. Muto, et al. (1995). "A case of an intra atrial tumor thrombus from hepatocellular carcinoma (HCC), first indicated by 67Ga citrate scintigraphy." Ann Nucl Med 9(1):

40 References Ohwada, S., Y. Tanahashi, et al. (1994). "Surgery for tumor thrombi in the right atrium and inferior vena cava of patients with recurrent hepatocellular carcinoma." Hepatogastroenterology 41(2): Okuda, K., S. Jinnouchi, et al. (1977). "Angiographic demonstration of growth of hepatocellular carcinoma in the hepatic vein and inferior vena cava." Radiology 124(1): Okuda, K., H. Musha, et al. (1975). "Demonstration of growing casts of hepatocellular carcinoma in the portal vein by celiac angiography: The thread and streaks sign." Radiology 117(2): Onitsuka, A., H. Hirose, et al. (1990). "Hepatoma with growth in right atrium: a report of successful resection." Dig Surg 7: Panidis, I. P., M. N. Kotler, et al. (1984). "Clinical and echocardiographic features of right atrial masses." Am Heart J 107(4): Pellicelli, A. M., J. Barba, et al. (1992). "Echocardiographic follow up of right atrial tumoral invasion by hepatocarcinoma: a case report." Cardiologia 37(2): Saisse, J., J. Hardwigsen, et al. (2001). "Budd Chiari syndrome secondary to intracardiac extension of hepatocellular carcinoma. Two cases treated by radical resection." Hepatogastroenterology 48(39): Scholte, A. J., P. H. Frissen, et al. (2004). "Transesophageal echocardiography guided transvenous biopsy of an intracardiac tumor." Echocardiography 21(8): Shyu, K. G., F. T. Chiang, et al. (1992). "Cardiac metastasis of hepatocellular carcinoma mimicking pericardial effusion on radionuclide angiocardiography." Chest 101(1): Simpson, W. M. (1924). "Tumor thrombosis of the inferior vena cava, with four additional cases of neoplastic invasion." Ann Clin Med 3: Sohn, J. W., Y. M. Yoon, et al. (1994). "Right atrial mass associated with hepatoma 2 case reports." Korean J Intern Med 9(2): Steffens, T. G., H. S. Mayer, et al. (1980). "Echocardiographic diagnosis of a right ventricular metastatic tumor." Arch Intern Med 140(1):

41 References Sternberg, K. (1901). "[Zwei Falle von Geschwulstthrombose der Vena cava inferior, Wien klin]." Wchnschr 14: Syed, H., S. Dubrey, et al. (2003). "Right atrial tumour mass of unusual origin." Heart 89(11): Takeda, T., N. Ishikawa, et al. (1985). "A giant tumor thrombus in the right atrium clearly detected by 111In oxine labeled platelet scintigraphy." Eur J Nucl Med 11(1): Tse, H. F., C. P. Lau, et al. (1996). "Transesophageal echocardiography in the detection of inferior vena cava and cardiac metastasis in hepatocellular carcinoma." Clin Cardiol 19(3): Van Camp, G., J. Abdulsater, et al. (1994). "Transesophageal echocardiography of right atrial metastasis of a hepatocellular carcinoma." Chest 105(3): Villet, W. T., E. G. Burger, et al. (1978). "Metastatic hepatocellular carcinoma of the heart. A case report." S Afr Med J 53(25): Vlasseros, I., E. Tapanlis, et al. (2003). "Metastatic hepatocellular carcinoma into the right atrium and ventricle: echocardiographic diagnosis and follow up." Echocardiography 20(4): Wang, J. N., J. S. Chen, et al. (2002). "Invasion of the cardiovascular system in childhood malignant hepatic tumors." J Pediatr Hematol Oncol 24(6): Wigmore, S. J. and O. J. Garden (1999). "Images in hepatology. Extension of hepatocellular carcinoma into the heart." J Hepatol 31(1): 160. Wilson, K., J. Guardino, et al. (2001). "Pulmonary tumor embolism as a presenting feature of cavoatrial hepatocellular carcinoma." Chest 119(2): Wu, C. C., S. Hseih, et al. (2000). "Surgical treatment for recurrent hepatocellular carcinoma with tumor thrombi in right atrium: using cardiopulmonary bypass and deep hypothermic circulatory arrest." J Surg Oncol 74(3): Yogita, S., S. Tashiro, et al. (2000). "Hepatocellular carcinoma with extension into the right atrium: report of a successful liver resection by hepatic vascular exclusion using cardiopulmonary bypass." J Med Invest 47(3 4):

42 References Yoshitomi, Y., S. Kojima, et al. (1998). "Echocardiography of a right atrial mass in hepatocellular carcinoma." Heart Vessels 13(1):

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