Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver. The Right heart is affected in up to 2% of metastatic HCC cases. However this was the first case of HCC to be reported with bi-atrial involvement. CECT showed Multifocal HCC in right lobe of liver with tumour thrombus extending along right portal vein, right hepatic vein into IVC and right atrium and extending across the atrial septum into left atrium via sinus venosus ASD. Intracardiac involvement has got very poor prognosis.

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Uthaya Sankar M.K

Professor, Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry-605107, India