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Histologically confirmed case of complete atrioventricular block due to hepatocellular carcinoma
  1. Takuro Nishiwaki1,
  2. Norihiko Yamamoto1,
  3. Yoshihumi Hirokawa2,
  4. Yoshiyuki Takei1
  1. 1Department of Gastroenterology and hepatology, Mie Daigaku Igakubu Fuzoku Byoin, Tsu, Mie, Japan
  2. 2Department of Oncologic Pathology, Mie University, Tsu, Mie, Japan
  1. Correspondence to Dr Norihiko Yamamoto, kotetsu{at}


A 72-year-old man, who had been diagnosed as having hepatocellular carcinoma (HCC) with multiple extrahepatic metastasis, complained a general fatigue which appeared 2 weeks before admission. Because bradycardia was detected on physical examination, ECG was performed which revealed the complete atrioventricular (AV) block. We stopped Ca-blocker and β-blocker, but the bradycardia persisted. He was admitted to our hospital for an emergent pacemaker implantation. On admission, he complained dyspnoea. After the surgery, he died due to deterioration of heart failure. The autopsy revealed cardiac metastasis of HCC on AV node, so it was suspected that cardiac metastasis caused the AV block. We thought that the cause of his death was the exacerbation of heart failure associated with bradycardia. It was likely that complete AV block as a very rare complication caused by cardiac metastasis of HCC influenced the prognosis of this patient.

  • hepatic cancer
  • pathology

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  • Contributors TN actually wrote this paper. NY performed patient’s care and designed this case presentation report, got a informed consent from patient’s family and proofread this article. YH performed the autopsy and diagnosed the case. YT finally checked this article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.