Hepatocellular carcinoma (HCC), the most common primary malignant tumour of the liver, is a highly vascular neoplasm usually arising in a cirrhotic liver. In addition to the diagnosis of primary lesion, an assessment for extrahepatic metastasis is needed. Herein, an extremely uncommon pattern of heart invasion in a patient with advanced HCC is described.

A 75-year-old man was admitted to the Hospital of Zumarraga, Zumarraga, Spain, for moderate abdominal pain, asthenia and weight loss. He denied having dyspnoea, orthopnoea, cough, palpitation or peripheral oedemas. Three years earlier, HCC had been diagnosed in the eighth segment, and the patient had received several courses of transcatheter …