SDMS CME Credit – Transesophageal Echocardiography: Timely Resolution of an Urgent Right Atrial Mass/ Hepatocellular Carcinoma Thrombosis

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Article: Transesophageal Echocardiography: Timely Resolution of an Urgent Right Atrial Mass/ Hepatocellular Carcinoma Thrombosis

Authors: Carmelo Pirri, PhD, MD, PT, Debora Emanuela Torre, MD, Stefano Cisico, MD, Laura Tini, MD, Carla Stecco, MD, Domenico Mangino, MD, and Raffaele De Caro, MD

Category: Adult Echo [AE]

Credit: 0.50 SDMS CME Credit

Objectives: After studying the article, you should be able to:

• Identify the anatomical structures associated with a transesophageal echocardiogram (TEE).

• Discuss patient symptoms surrounding a hepatocellular carcinoma (HCC).

• Explain a HCC, common sites of dissemination, and affected patient populations.

1. Hepatocellular carcinoma (HCC) is responsible for approximately what percentage of primary liver cancers?

2. B. 80%

3. C. 95%

4. D. 90%

Patient populations affected by HCC mainly consist of individuals with a history of:

A. Non-alcohol fatty liver disease

B. Chronic hepatitis, congestive heart failure, and diabetes

C. Cirrhosis, chronic hepatitis, and general pain

D. Cirrhosis, chronic hepatitis, or non-alcoholic fatty liver disease

What was observed in the patient from the case report based on the point of care ultrasonography (POCUS)?

A. An enlarged liver and abdominal mass

B. An enlarged liver and a mass in the right atrium

C. An enlarged liver

D. An enlarged liver, a mass in the right atrium, and a normal right ventricle

What does the transesophageal echocardiogram (TEE) show in Figure 1(A)?

A. A mid-esophageal bicaval view demonstrating the right atrial mass.

B. A bicaval view showing a free floating abdominal mass.

C. A bicaval view clearly showing that the right atrial mass has not extended through to the tricuspid valve.

D. A mid-esophageal four-chamber view demonstrating the floating giant right atrial mass.

The median overall survival rate of patients with HCC with a right atrial tumor thrombus treated with curative surgery ranges from 19.0 months to:

A. 30.8 months

B. 35 months

C. 32.3 months

D. 31.5 months