Résumé

Introduction: Hepatocellular carcinoma (HCC) is common in Côte d’Ivoire and is frequently diagnosed at an advanced or metastatic stage. We report a case of HCC with intracardiac involvement, an uncommon secondary site of this malignancy. Case presentation: A 45-year-old farmer with occupational pesticide exposure, no history of hepatitis B vaccination, and decompensated hepatitis C virus-related cirrhosis was referred in September 2025. Clinical, computed tomography, and laboratory findings supported a diagnosis of BCLC stage C, Child-Pugh class B HCC. Pretreatment Doppler echocardiography showed a tissue-density mass in the right atrium extending into the inferior vena cava, with preserved systolic function. A multidisciplinary tumor board recommended palliative systemic therapy with atezolizumab plus bevacizumab. The patient received one cycle but died six weeks after treatment initiation in the setting of a bevacizumab shortage. Conclusion: HCC is still frequently diagnosed at an advanced stage in our setting. Intracardiac involvement highlights its aggressive course and the importance of comprehensive staging.

Mot-clés :

Cardiac Metastasis; Hepatocellular Carcinoma; Côte D’ivoire.