Left atrial metastasis from hepatocellular carcinoma with liver cirrhosis.

Surgical treatment in hepatocellular carcinoma patients with cardiac involvement is challenging, and its prognosis remains unclear because of its rarity. A 48-year-old male hepatocellular carcinoma patient presented with right atrial involvement through the inferior vena cava and a left atrial mass, which nearly occluded the mitral valve, and extended from a pulmonary metastasis. Emergent surgery was performed due to sudden severe respiratory failure despite profound liver cirrhosis (Child-Pugh class B). Nevertheless, the patients postoperative course was uneventful, and over six months of follow-up, he has shown no remarkable symptoms and has maintained a tolerable liver function.