Cardiac metastasis of uterine cervical squamous cell carcinoma: A case report and review of the literature

Cardiac metastasis in uterine cervical cancer : A systematic review and case study

PURPOSE

Cardiac metastasis from cervical cancer is rare and only scarcely documented. We aim to present a new case and systematically summarize the available literature.

MATERIALS AND METHODS

PubMed, Scopus, Web of Science, Central, and ClinicalTrials.gov were systematically searched following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria. Results were screened via title, abstract, and full text. Additionally, the reference lists of all papers chosen for the review were screened.

RESULTS

Eighty-one papers were identified, describing 86 cases in total. Cardiac metastasis occurred at all stages of cervical cancer and in all age groups. Median time from initial diagnosis to diagnosis of cardiac metastasis was 12 months. Patients mainly complained of dyspnea and chest pain, 60.8% had pathologic ECG (electrocardiographic) findings. The cardiac mass was most frequently detected by transthoracic echography. The most common tumor histology was squamous cell carcinoma. Chemotherapy and surgical interventions were the main treatment modalities. Median survival after diagnosis of cardiac metastasis was 3 months.

CONCLUSION

This largest review on cardiac metastases from cervical cancer confirmed the heart as a very infrequent site of metastasis. There are < 100 cases described in the literature, with very poor prognosis and undefined clinical management.

Suction thrombectomy of a uterine carcinosarcoma tumor thrombus extending into the IVC and right atrium

Uterine carcinosarcoma is a rare, aggressive tumor with several cases in the literature reporting cardiac tumor thrombus involvement. In this case report, we describe a 72-year-old female with a history of uterine carcinosarcoma, who presented with extensive thrombus in the Inferior Vena Cava (IVC) and right atrium. The patient underwent an aspiration thrombectomy which aided in intravascular debulking of the thrombus. Histopathological analysis of the thrombus revealed tumor thrombus. In cryptic cases of tumor thrombus, thrombectomy with histopathological analysis can help confirm the diagnosis of metastatic disease and help guide oncologic staging and further therapy.

A rare case of cardiac metastasis of squamous cell carcinoma of the cervix with a review of existing case reports and treatment modalities

•Cardiac metastasis is a rare complication of squamous cell carcinoma of the cervix.•Biologic agents may be a useful treatment modality for cardiac metastasis of squamous cell carcinoma of the cervix.•Multidisciplinary approach is required to treat cardiac metastasis of squamous cell carcinoma of the cervix.

A Rare Case of Intracavitary Cardiac Metastasis of Endometrial Carcinosarcoma

A 59-year-old female, with past medical history including endometrial carcinosarcoma with a port-a-cath device, presented due to shortness of breath. Transesophageal echocardiogram demonstrated a mass extending from the right atrium, involving the tricuspid valve, and extending into the right ventricle. Our differential diagnosis included thrombus as well as endocarditis and malignancy; a thrombus was considered to be the most likely etiology due to the port-a-cath device. Use of the novel AngioVac mechanical aspiration device (AngioDynamics, 2021) allowed removal of the mass as well as evaluation by pathology, establishing the unlikely diagnosis of metastatic endometrial carcinosarcoma. 

A rare case of cardiac metastasis from uterine cervical adenocarcinoma

Metastatic cardiac tumors are rare and are usually from lung, breast, and esophageal cancers. Although uterine cervical cancer is relatively common, its metastasis to the heart is extremely rare. Herein, we report an unusual case of metastatic cervical adenocarcinoma to the heart presenting with a huge right atrial mass and tamponade. The cardiac mass was surgically resected and pathologic study with immunohistochemistry staining confirmed the diagnosis. <Learning objective: Metastatic cardiac tumors are rare. They usually originate from lung, breast, and esophageal cancers and mostly involve the pericardium and myocardium. The endocardium is rarely affected. Cervical cancer is one of the most common gynecologic cancers with a relatively favorable prognosis unless it metastasizes to distant organs. Metastases to the heart are rarely reported. The patient may be asymptomatic or present with hemodynamic instability due to tamponade state and/or a huge intracardiac mass.>.

Cardiac metastasis in a living patient with oral cancer

Cardiac metastasis from head and neck cancers are very rare. Metastases to heart are mostly diagnosed at autopsy, and seldom found while patients are alive. Patients with cardiac metastasis do not present with specific symptoms in the early stages, and diagnosis is often delayed until the disease has advanced significantly. Here, we report a 66-year-old lady who was diagnosed with cardiac metastasis 10 months after surgical resection of oral cancer. She died one month following the discovery of cardiac metastasis. Cardiac metastasis should be considered when unexplained and progressive decline of general health is observed, even in the absence of abnormalities on the electrocardiogram. Early diagnosis may be made by analyzing the chronological changes in the cardiac accumulation of fluorodeoxyglucose during positron emission tomography-computed tomography scan.