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  • Title: Clinical examination remains crucial to the correct diagnosis: a case of severe peripheral oedema referred for investigation of heart failure.
    Author: Mengi S, Phelps L, Silva TSCD, Ludman A.
    Journal: BMJ Case Rep; 2019 Aug 01; 12(7):. PubMed ID: 31371329.
    Abstract:
    Hepatocellular carcinoma (HCC) uncommonly metastasises to the heart. We present a case of new onset bilateral leg swelling and suspected right heart failure in a previously fit and healthy man, which on further investigation revealed a new diagnosis of HCC with extension into the inferior vena cava and right atrium. This case highlights the importance of considering alternative possibilities when physical examination does not match the initial clinical diagnosis. The management approach was for best supportive care in view of extensive metastatic disease.
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