Echocardiographic findings of mobile atrial hepatocellular carcinoma. Report of five cases.

Hepatoma with cardiac metastasis is difficult to diagnose antemortem. Herein we describe five cases of hepatoma with intracardiac metastasis detected with two-dimensional echocardiography (2DE). The clinical presentations include cardiac murmur, syncope, and chest pain. The 2DE demonstrated a right atrial (RA) mass in each case and the presence of tumor echoes in the inferior vena cava connecting with the RA mass in four. In three cases the cardiac tumor was removed, whereas the other two patients agreed only to liver biopsy, which confirmed the diagnosis. This paper emphasizes the practical utility of 2DE for early detection of intracardiac hepatoma and also describes the clinicopathologic correlation of such a disease entity.