Progressive dyspnea and a right atrial mass in an 80-year-old man
Hepatocellular carcinoma (HCC) is among the five most frequent causes of cancer death worldwide, according to the WHO. The disease is related to alcohol abuse, viral infections, and other causes of cirrhosis, and unfortunately, in some developed countries, the incidence shows an increasing trend. Al...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
University of São Paulo
2019-11-01
|
| Series: | Autopsy and Case Reports |
| Subjects: | |
| Online Access: | http://www.revistas.usp.br/autopsy/article/view/164492 |
| _version_ | 1818807388375875584 |
|---|---|
| author | Vera Demarchi Aiello Ryan Yukimatsu Tanigawa Rodrigo Caruso Chate Fernando Peixoto Ferraz de Campos Alfredo José Mansur |
| author_facet | Vera Demarchi Aiello Ryan Yukimatsu Tanigawa Rodrigo Caruso Chate Fernando Peixoto Ferraz de Campos Alfredo José Mansur |
| author_sort | Vera Demarchi Aiello |
| collection | DOAJ |
| description | Hepatocellular carcinoma (HCC) is among the five most frequent causes of cancer death worldwide, according to the WHO. The disease is related to alcohol abuse, viral infections, and other causes of cirrhosis, and unfortunately, in some developed countries, the incidence shows an increasing trend. Although the diagnosis of the HCC often relies upon the context of a chronic hepatopathy, some cases may present a silent course, and the initial symptoms ensue when the disease is in an advanced stage with no chance for any therapeutic attempt. The clinical picture of the HCC is varied, and unexpected forms may surprise the clinician. One of the unusual presentations of the HCC is shock by the blockage of the venous return to the right atrium by the inferior vena cava infiltration. Herein we present a case of an old patient who sought medical care complaining of dyspnea. The clinical workup disclosed a right thorax pleural effusion and imaging exams depicted a mass in the right hepatic lobe, invasion of the inferior vena cava (IVC) and the right atrium (RA). During the attempts of clinical investigation, the patient passed away. The autopsy disclosed an HCC involving the right hepatic lobe, with the invasion of the IVC and the RA. The authors highlight the importance of recognizing the bizarre presentation of not so rare diseases. |
| first_indexed | 2024-12-18T19:24:52Z |
| format | Article |
| id | doaj.art-bf8204f2639946e7973629687d03a0f8 |
| institution | Directory Open Access Journal |
| issn | 2236-1960 |
| language | English |
| last_indexed | 2024-12-18T19:24:52Z |
| publishDate | 2019-11-01 |
| publisher | University of São Paulo |
| record_format | Article |
| series | Autopsy and Case Reports |
| spelling | doaj.art-bf8204f2639946e7973629687d03a0f82022-12-21T20:55:54ZengUniversity of São PauloAutopsy and Case Reports2236-19602019-11-019410.4322/acr.2019.135Progressive dyspnea and a right atrial mass in an 80-year-old manVera Demarchi Aiello0Ryan Yukimatsu Tanigawa1Rodrigo Caruso Chate2Fernando Peixoto Ferraz de Campos3Alfredo José Mansur4Universidade de São Paulo, Medical School, Heart InstituteUniversidade de São Paulo, Medical SchoolUniversidade de São Paulo, Medical SchoolUniversidade de São Paulo, Hospital UniversitárioUniversidade de São Paulo, Medical SchoolHepatocellular carcinoma (HCC) is among the five most frequent causes of cancer death worldwide, according to the WHO. The disease is related to alcohol abuse, viral infections, and other causes of cirrhosis, and unfortunately, in some developed countries, the incidence shows an increasing trend. Although the diagnosis of the HCC often relies upon the context of a chronic hepatopathy, some cases may present a silent course, and the initial symptoms ensue when the disease is in an advanced stage with no chance for any therapeutic attempt. The clinical picture of the HCC is varied, and unexpected forms may surprise the clinician. One of the unusual presentations of the HCC is shock by the blockage of the venous return to the right atrium by the inferior vena cava infiltration. Herein we present a case of an old patient who sought medical care complaining of dyspnea. The clinical workup disclosed a right thorax pleural effusion and imaging exams depicted a mass in the right hepatic lobe, invasion of the inferior vena cava (IVC) and the right atrium (RA). During the attempts of clinical investigation, the patient passed away. The autopsy disclosed an HCC involving the right hepatic lobe, with the invasion of the IVC and the RA. The authors highlight the importance of recognizing the bizarre presentation of not so rare diseases.http://www.revistas.usp.br/autopsy/article/view/164492CarcinomaHepatocellularEmbolismLiver NeoplasmsBudd-Chiari Syndrome |
| spellingShingle | Vera Demarchi Aiello Ryan Yukimatsu Tanigawa Rodrigo Caruso Chate Fernando Peixoto Ferraz de Campos Alfredo José Mansur Progressive dyspnea and a right atrial mass in an 80-year-old man Autopsy and Case Reports Carcinoma Hepatocellular Embolism Liver Neoplasms Budd-Chiari Syndrome |
| title | Progressive dyspnea and a right atrial mass in an 80-year-old man |
| title_full | Progressive dyspnea and a right atrial mass in an 80-year-old man |
| title_fullStr | Progressive dyspnea and a right atrial mass in an 80-year-old man |
| title_full_unstemmed | Progressive dyspnea and a right atrial mass in an 80-year-old man |
| title_short | Progressive dyspnea and a right atrial mass in an 80-year-old man |
| title_sort | progressive dyspnea and a right atrial mass in an 80 year old man |
| topic | Carcinoma Hepatocellular Embolism Liver Neoplasms Budd-Chiari Syndrome |
| url | http://www.revistas.usp.br/autopsy/article/view/164492 |
| work_keys_str_mv | AT verademarchiaiello progressivedyspneaandarightatrialmassinan80yearoldman AT ryanyukimatsutanigawa progressivedyspneaandarightatrialmassinan80yearoldman AT rodrigocarusochate progressivedyspneaandarightatrialmassinan80yearoldman AT fernandopeixotoferrazdecampos progressivedyspneaandarightatrialmassinan80yearoldman AT alfredojosemansur progressivedyspneaandarightatrialmassinan80yearoldman |