<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2341-4545</journal-id>
<journal-title><![CDATA[GE-Portuguese Journal of Gastroenterology]]></journal-title>
<abbrev-journal-title><![CDATA[GE Port J Gastroenterol]]></abbrev-journal-title>
<issn>2341-4545</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Gastrenterologia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2341-45452023000100057</article-id>
<article-id pub-id-type="doi">10.1159/000519545</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Isolated Intracardiac Metastasis: The First Sign of Hepatocellular Carcinoma]]></article-title>
<article-title xml:lang="pt"><![CDATA[Metástase intracardíaca isolada: O primeiro sinal de carcinoma hepatocelular]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Paixão]]></surname>
<given-names><![CDATA[Anusca]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Rita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lopes]]></surname>
<given-names><![CDATA[Natália]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carvalho]]></surname>
<given-names><![CDATA[Sónia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carrola]]></surname>
<given-names><![CDATA[Paulo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Presa Ramos]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital de São Pedro Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Vila Real ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>02</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>02</month>
<year>2023</year>
</pub-date>
<volume>30</volume>
<numero>1</numero>
<fpage>57</fpage>
<lpage>60</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2341-45452023000100057&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2341-45452023000100057&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2341-45452023000100057&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Metastatic hepatocellular carcinoma (HCC) to the right atrium without invasion of the inferior vena cava is a very rare and difficult diagnosis, especially when the primary tumour is yet to be known. A 68-year-old man with symptoms of heart failure was admitted to the emergency department; his transthoracic echocardiogram showed a mass comprehending almost the totality of the right atrium, obliterating its entrance nearly completely and impeding the normal auricular-ventricular flux, described as a possible auricular myxoma. The patient was promptly transferred to cardiothoracic surgery and submitted to an urgent surgery to completely remove the mass, which was macroscopically described as suspected of malignancy. Further investigation demonstrated a single nodule in the liver with malignant imging characteristics, and the histology confirmed the diagnosis of metastatic HCC of the right atrium, without metastatic disease elsewhere. He was then submitted to radiofrequency ablation and medicated with sorafenib. The disease progressed slowly but subsequently involved the inferior vena cava and portal vein, culminating in his death 4 years and 3 months after the diagnosis. Although the prognosis for metastatic HCC may be poor, especially with intracavitary heart metastasis, this case shows that an aggressive initial approach with surgical metastasectomy may prolong the median survival of the patients.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo A metastização intracardíaca de um carcinoma hepatocelular sem invasão da veia cava inferior é um diagnóstico raro e difícil, especialmente quando o tumor primário não foi ainda diagnosticado. Um homem de 68 anos foi admitido no Serviço de Urgência com sintomas de insuficiência cardíaca aguda. O ecocardiograma transtorácico mostrou uma massa que atingia quase a totalidade da aurícula direita, praticamente obliterando a sua entrada e impedindo o normal fluxo auriculoventricular, descrita como possível mixoma auricular. O doente foi imediatamente transferido para cirurgia cardiotorácica e submetido a cirurgia urgente para resseção da massa que foi macroscopicamente descrita como suspeita de malignidade. A investigação subsequente demonstrou um nódulo isolado hepático com características imagiológicas de malignidade, e a histologia da massa auricular confirmou o diagnóstico de metastização auricular de carcinoma hepatocelular. O doente foi posteriormente submetido a ablação por radiofrequência e medicado com sorafenib, com progressão lenta mas contínua da doença e subsequente atingimento metastático da veia cava inferior e veia porta, que culminou na sua morte quatro anos e três meses após o diagnóstico. Apesar do prognóstico ser reservado para o carcinoma hepatocelular metastático, especialmente na presença de metástases intracardíacas, este caso clínico mostra que uma abordagem inicial mais agressiva com metastasectomia pode prolongar a sobre-vida média dos doentes.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Acute heart failure]]></kwd>
<kwd lng="en"><![CDATA[Isolated cardiac metastasis]]></kwd>
<kwd lng="en"><![CDATA[Hepatocellular carcinoma]]></kwd>
<kwd lng="pt"><![CDATA[Insuficiência cardíaca aguda]]></kwd>
<kwd lng="pt"><![CDATA[Metástase cardíaca isolada]]></kwd>
<kwd lng="pt"><![CDATA[Carcinoma hepatocelular]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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