[Hepatocellular carcinoma with extension per continuitatem into the right atrium]. / Hepatozelluläres Karzinom mit Ausbreitung per continuitatem in den rechten Vorhof.

HISTORY AND CLINICAL FINDINGS: A 61-year-old asymptomatic patient presented with a hepatocellular carcinoma and a history of 11 cycles of transarterial chemoembolization. Staging investigations revealed an enlarged hepatic tumour and a right atrial mass. INVESTIGATIONS: Computed tomography of chest and abdomen showed a progressive tumour in both hepatic lobes with extension to the inferior vena cava, through the diaphragma and to the right atrium. TREATMENT AND COURSE: The patient received supportive treatment and died 3 months later. CONCLUSION: Inspite the incidence of 1-4%, hepatocellular carcinoma with extension to the heart has been diagnosed rarely. Although treatment is limited, early diagnosis by abdominal echography or echocardiography is necessary for the interpretation of cardiogenic symptoms and the prognosis.

Concepts of a Web-based open distributed textbook for the multimodal diagnostics of gastrointestinal tumours with MRI, CT and video-endoscopy addressing students of medicine and students of medical informatics as two different target groups.

Multimodal diagnostics of gastrointestinal tumours with MRI, CT and video-endoscopy is a rapidly changing domain. The education at our universities should overcome the obstacles of traditional learning based on paper media and oral lectures with retention rates of 10-30% only. The paper presents the objectives and the results of the design phase of the project ODITEB1-Open Distributed TExt Book, for Computer-Assisted Instruction in the domain mentioned above. The main objective is to produce an electronic interactive textbook in order to shift education to more efficient learning settings with higher retention rates. The main concepts are 1) three-layer architecture (dynamic case layer, intermediate query layer, static instruction layer) 2) case pool distribution 3) active learners experience (interactive exploration of original image data).