Hepatocellular carcinoma, extension into the right atrium per continuitatem

History and clinical findings: A 61-year-old asymtomatical patient presente d with a hepatocellular carcinoma and a history of 11 cycles of transarteri ell chemoembolization. Staging investigations revealed an enlarged hepatic tumour and a right atrial mass. Investigations: Computed tomography of chest and abdomen showed a pregredie nt tumour in both hepatic lobes with extension to the inferior vena cava, t hrough the diaphragma and to the right atrium. Treatment and course: The patient received supportive treatment and died 3 months later. Conclusion: Inspite the incidence of 1-4%, hepatocellular carcinoma with ex tension to the heart has been diagnosed rarely. Although treatment is limit ed, early diagnosis by abdominal echography or echocardiography is neccessa ry for the interpretation of cardiogenic symptoms and the prognosis.