Recent signs imitating hypertrophic cardiomyopathyfive years after resection of a primary hepatocellular carcinoma

HISTORY AND ADMISSION FINDINGS: A 42-year-old womenpresented with shortness of breath, tachycardia and weakness toour department. Five years ago she had been diagnosed with hepatocellularcarcinoma for which an extended hemihepatectomy had been performed. INVESTIGATIONS, DIAGNOSIS AND TREATMENT: Theclinical examination revealed a systolic murmur over the artic region.Echocardiography showed an hypertrophed interventricular septumwithsigns like those in hypertrophic obstructive cardiomyopathy. Ultrasounddemonstrated a cystic mass in the pelvis highly suspicious of ametastasis of a hepatocellular carcinoma. Fine needle biopsyconfirmedthe diagnosis of a metastatic lesion of hepatocellular carcinoma.Computed tomography demonstrated metastase in the lung and a space-occupyingin the interventricular septum. The patients underwent resectionof the lung and pelvic metastasis and died a few weeks later. CONCLUSION: This case demonstrates therare occurence of a metastasis to the heart, imitating obstructivecardiac myopathy, in a patient with hepatocellular carcinoma.