Hepatocellular Carcinoma With a Floating Right Atrial Thrombus and Rupture of the Primary Lesion Causing Right-Sided Hemothorax

Abstract

A 68-year-old gentleman presented to us with a low back ache and paraparesis. Magnetic resonance imaging of the spine revealed vertebral body lesion compressing the spinal cord. As part of the preoperative evaluation for spinal decompression surgery, an echocardiography was done which revealed a normal heart with a floating mass in right atrium extending from the inferior vena cava. On further workup, he was diagnosed to have hepatocellular carcinoma with vertebral metastasis. Subsequently, the primary lesion ruptured leading to massive right-sided hemothorax.