Rapid Communication
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jun 14, 2008; 14(22): 3563-3568
Published online Jun 14, 2008. doi: 10.3748/wjg.14.3563
Imaging findings and transcatheter arterial chemoembolization of hepatic malignancy with right atrial embolus in 46 patients
Hong-Yan Cheng, Xiao-Yan Wang, Guo-Li Zhao, Dong Chen
Hong-Yan Cheng, Xiao-Yan Wang, Guo-Li Zhao, Dong Chen, Department of Radiology, Eastern Hepatobiliary Surgery Hospital, 225 Changhai Road, Shanghai 200438, China
Author contributions: Cheng HY designed the research, Cheng HY and Wang XY wrote the paper, Cheng HY, Zhao GL and Chen D performed the research and analyzed the data.
Correspondence to: Hong-Yan Cheng, MD, Department of Radiology, Eastern hepatobiliary Surgery Hospital, 225 Changhai Road, Shanghai 200438, China. chengys9304@yahoo.com.cn
Telephone: +86-21-25070861
Fax: +86-21-25070861
Received: November 20, 2007
Revised: March 20, 2008
Accepted: March 27, 2008
Published online: June 14, 2008
Abstract

AIM: To analyze the imaging findings of hepatic malignancy with right atrial (RA) embolus.

METHODS: Forty-six patients with an embolus in the RA were diagnosed, including 44 patients with hepatocellular carcinoma (HCC), 1 patient with cholangiocellular carcinoma and 1 patient with hepatic carcinoma metastasis. The diagnosis was confirmed by clinical examination, serum α-fetoprotein and imaging. Seventeen patients underwent transcatheter arterial chemoembolization (TACE).

RESULTS: On enhancement computer tomography (CT) or magnetic resonance (MR) imaging, a nodular filling defect in the RA could be easily found, with a slight enhancement in the arterial phase. The coronal images of CT or MR showed the extent of lesion. Lipiodol entered the embolus after TACE, hence reducing the speed of embolus growth. There was a survival benefit for patients receiving anticancer treatment.

CONCLUSION: Patients with HCC, showing a filling defect of the inferior vena cava (IVC), hepatic vein (HV) and RA on images, can be diagnosed with RA embolus. Encroachment of the RA is very rare in patients with hepatic malignancies. Furthermore, a prolongation of survival time is found in those patients who underwent TACE.

Keywords: Carcinoma; Liver; Neoplasm; Metastasis; Embolus; Right atrium; Computed tomography; X-Ray; Magnetic resonance