Hepatocellular carcinoma (HCC) is a well-known complication of chronic hepatitis-B and is associated with chronic alcoholism. Most cases of HCC are diagnosed at an advanced stage and the tumor spreads most frequently to the lungs, peritoneum, adrenal glands, and bones. The aim of this study was to clarify the clinical features of patients with isolated rare HCC metastases to the heart. A 65‑year‑old male was hospitalized with the history of palpitations and exertional dyspnea since eight days. He also had four syncopal attacks since last two weeks. USG-abdomen revealed a tumor of right lobe of liver. Cardiac magnetic resonance imaging (MRI) and echocardiography revealed a round metastatic tumor in the right ventricle (RV) with liver tumor as the primary. The patient succumbed to death before CT-guided biopsy on eight day of admission. A pathological autopsy revealed HCC without portal tumor thrombi and without metastases to the lungs, inferior vena cava (IVC) and RA. The metastases were only noted in RV which was not continuous with the intrahepatic tumor and were histologically attached to endocardium of RV. Such cases have poor prognosis. Prompt diagnosis and faster therapy is only way to avoid HCC related deaths.
