Isolated cardiac metastases of hepatocellular carcinoma after resection: a case report

A 76-year-old man was diagnosed with multiple hepatocellular carcinomas (HCCs). He underwent right lobectomy and partial resection of the liver after transcatheter arterial embolization at our hospital. The pathology report was moderately differentiated HCC (fT4N0M0 Stage Iva, Vp1, Vv0). Follow-up CT revealed a lesion in the right ventricle 3 years after surgery. Moderately differentiated HCC was determined on myocardial biopsy, and the lesion was diagnosed as cardiac metastasis of HCC. No recurrence of HCC was observed in the liver. Radiation therapy (39 Gy/13 fr) was performed for the cardiac metastasis, and oral lenvatinib 8 mg/day was started. Evaluation by mRECIST on contrast-enhanced CT indicate a partial response (PR). Lenvatinib has been continued for 7 months. Cardiac metastasis of HCC is extremely rare; herein, we have also provided a literature reviews.