Abstract: Objective The ultrasonographic feature and prognosis of patients with hepatocellular carcinoma (HCC) and cardiac metastasis were summarized. Methods A total of 19 patients with HCC and cardiac metastasis were admitted to our hospital between January 2013 and May 2019, and all patients underwent ultrasonography and followed-up for 12 months. The diagnosis was confirmed by histopathological examination. Results The solid echo was observed in adjacent hepatic veins and extended to inferior vena cava and right atrium in 16 cases (84%), the solid echogenicity was observed in adjacent inferior vena cava and extended to right atrium in 3 cases (16%), the mixed echo was found in 13 cases (68%) and the hypoechoic in 6 cases (32%); the clear boundaries was found in 15 cases (79%) and the irregular morphology was found in 16 cases (89%); there was no blood flow signal of tumor thrombus in the right atrial in 19 cases (100%); no relationship with cardiac cycle was found in 12 cases 63%, and no significant relationship with cardiac cycle was found in 7 cases (37%); the right ventricular inflow tract was involved in 3 cases (16%); the survival time after right atrial metastasis was found was 25 to 412 days, and acute pulmonary embolism was found in 2 patients. Conclusion The continuous cancerous thrombus extending from hepatic vena to inferior vena cava to right atrium or to inferior vena cava to right atrium is the most important ultrasonographic manifestations in patients with HCC and cardiac metastasis. The patients at this circumstance have a very short survival time and might have acute pulmonary embolism at any time.

Key words: Hepatoma, Cardiac metastasis, Ultrasound, Prognosis