1
|
Hopman LHGA, Frenaij IM, Heidendael JF, Selder JL, Robbers LFHJ. Cardiovascular magnetic resonance imaging characteristics of a myocardial metastatic melanoma. Eur Heart J Cardiovasc Imaging 2024; 25:e154. [PMID: 37990941 PMCID: PMC11057919 DOI: 10.1093/ehjci/jead326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/16/2023] [Accepted: 11/19/2023] [Indexed: 11/23/2023] Open
Affiliation(s)
- Luuk H G A Hopman
- Department of Cardiology, Amsterdam UMC, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands
| | - Irene M Frenaij
- Department of Cardiology, Amsterdam UMC, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands
| | - Josephine F Heidendael
- Department of Cardiology, Amsterdam UMC, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands
| | - Jasper L Selder
- Department of Cardiology, Amsterdam UMC, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands
| | - Lourens F H J Robbers
- Department of Cardiology, Amsterdam UMC, De Boelelaan 1118, 1081 HV Amsterdam, The Netherlands
| |
Collapse
|
2
|
Ma YY, Li ZK, Liao ZY, Peng Y, Zeng L, Ma DY. Brain radiotherapy and anlotinib control primary cardiac angiosarcoma with metastases: A case report. Medicine (Baltimore) 2024; 103:e37914. [PMID: 38669418 PMCID: PMC11049782 DOI: 10.1097/md.0000000000037914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
RATIONALE Primary cardiac angiosarcoma (PCA) is a rare and fatal disease with a poor prognosis. Whether the survival of PCA patients can be prolonged with additional treatment following complete surgical excision is controversial. PATIENT CONCERNS In this case study, a 52-year-old male complained of chest tightness and pain for 7 days before admission into the hospital. Subsequently, he revisited the hospital because of dizziness and headache. DIAGNOSES Initially, the patient was diagnosed with PCA in the right atrium by thoracic computed tomography (CT). Palliative resection identified brain, lung, and liver metastases. INTERVENTION The patient accepted multimodal combination therapy, including first-line chemotherapy and then second-line anlotinib concurrent with brain radiotherapy and immunotherapy. OUTCOME Although anlotinib combined with brain radiotherapy controlled the growth of intracranial lesions, progression-free survival (PFS) was only 5 months, and the overall survival (OS) was only 12 months. LESSON The treatment for metastatic PCA needs an in-depth exploration.
Collapse
Affiliation(s)
- Ying-Ying Ma
- Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Zhi-Ke Li
- Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Zi-Yi Liao
- Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yang Peng
- Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Li Zeng
- Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Dai-Yuan Ma
- Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| |
Collapse
|
3
|
Chan HY, Chan WY, Lin JWS. Cardiac and Intramuscular Metastases Following Nephroureterectomy for Metachronous Urothelial Carcinoma. Am J Case Rep 2024; 25:e942864. [PMID: 38650318 PMCID: PMC11056213 DOI: 10.12659/ajcr.942864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 03/13/2024] [Accepted: 02/28/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND We present a case of metachronous cardiac and intramuscular metastases in a patient with a known history of radical nephroureterectomy for upper-tract urothelial carcinoma (UTUC). CASE REPORT A 58-year-old man had a history of metachronous renal pelvis urothelial carcinoma with prior left radical nephroureterectomy. He was also diagnosed with malignancy-associated deep vein thrombosis (DVT) and was on rivaroxaban. He presented at an oncology follow-up consult with shortness of breath and right scapular lump. CT scan revealed a soft-tissue mass at the surgical bed suspicious for local recurrence, as well as intracardiac hypodensities and intramuscular nodules in the right latissimus dorsi and right adductor muscles. The intracardiac hypodensities were located in the left atrial appendage and inter-atrial septum. Given that the patient had a history of DVT and in a pro-thrombotic state, differentials for the intracardiac densities included intracardiac thrombi or metastases. The intramuscular hypodensities were rim-enhancing. Given that the patient was on rivaroxaban, differentials included hematomas or metastases. As there was no overlying bruising and the lesions remained unchanged in size clinically, they were treated as metastases. The patient was treated with clexane but re-presented with worsening of shortness of breath and palpitations. CT scan showed increased size of intracardiac lesions, suggesting no response to anticoagulation, and therefore were likely metastatic in nature. He completed a 2-year course of IV pembrolizumab and was in complete remission. CONCLUSIONS Our case highlights the importance of this clinically challenging scenario when patients with known malignancy and on anticoagulation present with cardiac or musculoskeletal symptoms. Though these patients are at risk of thrombus and haematoma, cardiac and intramuscular metastasis should be considered, as the prognosis is guarded.
Collapse
|
4
|
Wen YL, Ma GT, Miao Q. [Diagnosis and treatment of intravenous leiomyomatosis]. Zhonghua Wai Ke Za Zhi 2023; 61:1051-1057. [PMID: 37932140 DOI: 10.3760/cma.j.cn112139-20230310-00099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Intravenous leiomyomatosis is a rare type of tumor that is histologically benign but biologically invasive. It originates from the smooth muscle of the uterine or the uterine vein. It can grow through the uterus and extend into the pelvic cavity, or grow along the veins without invading the wall of the venous vessel itself. The tumors are estrogen-dependent and can metastasize through the bloodstream. Thus, in addition to continuous growth, some tumors exhibit isolated growths in the venous system and heart chambers or show disseminated growth in the lungs, although distant metastasis to other regions usually do not occur. Currently, there is limited research on this disease, the majority of which are case reports, surgical experience summaries, and differentiation from ordinary gynecological myomas in terms of pathogenesis and radiological diagnostic experience. There are two main theories on the origin of the disease: uterine smooth muscle and smooth muscle of the uterine veins. Some studies have verified the role of estrogen, progesterone receptor-related pathways, and angiogenesis in the development of the disease. The clinical symptoms of this disease are varied, depending on the affected area. In the early stages, when the tumor only affects the pelvic cavity, patients show mild symptoms resulting from pelvic organ compression. When it progresses to the inferior vena cava and heart, patients show more complex symptoms resulting from venous return obstruction, cardiac obstruction, and hemodynamics appearing. Different institutions have proposed different disease staging and classification strategies for different clinical purposes. Some are based on the affected area of the lesion; others are based on the size of the tumor. Although surgery remains the main treatment for this disease, the specific surgical approach, adjuvant drug therapy, and prognosis still need further exploration.
Collapse
Affiliation(s)
- Y L Wen
- Department of Cardiac Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - G T Ma
- Department of Cardiac Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Q Miao
- Department of Cardiac Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| |
Collapse
|
5
|
Yoshihara S. Pazopanib-induced regression of metastatic cardiac tumor from uterine leiomyosarcoma evaluated by cardiac computed tomography. Ginekol Pol 2023; 95:169-170. [PMID: 37642247 DOI: 10.5603/gpl.93941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/14/2023] [Accepted: 06/19/2023] [Indexed: 08/31/2023] Open
Affiliation(s)
- Shu Yoshihara
- Departments of Diagnostic Radiology, Iwata City Hospital, Iwata, Japan, Japan.
| |
Collapse
|
6
|
Nova-Camacho LM, Gomez-Dorronsoro M, Guarch R, Cordoba A, Cevallos MI, Panizo-Santos A. Cardiac Metastasis From Solid Cancers: A 35-Year Single-Center Autopsy Study. Arch Pathol Lab Med 2023; 147:177-184. [PMID: 35639589 DOI: 10.5858/arpa.2021-0418-oa] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2021] [Indexed: 02/05/2023]
Abstract
CONTEXT.— Cardiac metastases are more prevalent than primary cardiac tumors, and although rare, the incidence is anticipated to increase with the extended survival of oncology patients. OBJECTIVE.— To estimate the current incidence of cardiac metastasis from solid tumors in adult autopsies. DESIGN.— Adult autopsy cases from 1984 through 2019 from patients diagnosed with any type of solid cancer were retrieved. The medical charts and pathologic autopsy data were reviewed in detail. RESULTS.— A total of 1294 adult autopsies performed on patients diagnosed with any type of cancer within the past 35 years were reviewed. We found 124 secondary cardiac tumors. Eighty-five were due to cardiac involvement by solid tumors. Of these, 61 were true cardiac metastases of solid cancers. We focused on these 61 cases. The age range was 32 to 85 years. Forty-four patients were men and 17 were women. The lung was the most common primary site, with 21 cases (34.43%). The most frequent histologic type was carcinoma, with 54 cases (88.52%). The predominant layer of the heart involved was the pericardium, with 35 cases (57.38%). Twenty-one cases (34.43%) had pericardial effusion, with 4 being hemorrhagic. All cases had multiple extracardiac metastases, with 56 cases (91.8%) having distant metastases in 4 or more different organs. CONCLUSIONS.— Cardiac metastasis is a rare occurrence, with an incidence of 4.71% (61 of 1294 cases) in our series. Lung cancer accounted for most of the cardiac metastases seen, and carcinomas were the most frequent histologic type. The pericardium was the most frequent location. Cardiac metastases occurred most frequently in cases of massive metastatic dissemination.
Collapse
Affiliation(s)
- Luiz M Nova-Camacho
- From the Department of Pathology, Hospital Universitario de Navarra, Pamplona, Spain
| | | | - Rosa Guarch
- From the Department of Pathology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Alicia Cordoba
- From the Department of Pathology, Hospital Universitario de Navarra, Pamplona, Spain
| | - M Isabel Cevallos
- From the Department of Pathology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Angel Panizo-Santos
- From the Department of Pathology, Hospital Universitario de Navarra, Pamplona, Spain
| |
Collapse
|
7
|
Sajdok M, Kawa M, Miszczyk M, Błach A, Chrabański O, Soral T, Śmietana A, Stadnik D, Musik P, Biernat J, Deja M, Gołba KS. Melanoma metastasis of the heart: Case report of an atypical metastatic location. Kardiol Pol 2023; 81:1290-1292. [PMID: 38189510 DOI: 10.33963/v.kp.97945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Mateusz Sajdok
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland.
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland.
| | - Michał Kawa
- Student's Scientific Society, Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Marcin Miszczyk
- 3rd Radiotherapy and Chemotherapy Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Anna Błach
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
- Department of Nuclear Medicine, Voxel Diagnostic Center, Katowice, Poland
| | - Olgierd Chrabański
- Department of Nuclear Medicine, Voxel Diagnostic Center, Katowice, Poland
- Department of Radiodiagnostics, Interventional Radiology and Nuclear Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
- Department of Nuclear Medicine and Endocrine Oncology, Maria Skodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Tomasz Soral
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Adam Śmietana
- Student's Scientific Society, Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Daniel Stadnik
- Student's Scientific Society, Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
- Department of Pneumonology, Upper Silesian Medical Center, Medical University of Silesia, Katowice, Poland
| | - Paulina Musik
- Student's Scientific Society, Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| | - Jolanta Biernat
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
| | - Marek Deja
- Department of Cardiac Surgery, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
- Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland
| | - Krzysztof S Gołba
- Department of Electrocardiology, Upper Silesian Heart Center, Medical University of Silesia, Katowice, Poland
- Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
| |
Collapse
|
8
|
Muraoka T, Shimada K, Takekubo M. [Metastatic Right Ventricular Tumor Eleven-year after Nephrectomy for Renal Cell Carcinoma]. Kyobu Geka 2022; 75:612-616. [PMID: 35892301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Metastatic heart tumors make up the majority of heart tumors and are 20 to 40 times more frequent than primary heart tumors. Cardiac metastasis of renal cell carcinoma is often asymptomatic until advanced stage, and there are few reports of surgical tumor resection for metastatic heart tumors at very late term. We experienced a case of metastatic right ventricular tumor eleven-year after nephrectomy for renal cell carcinoma. Tumor resection was performed under cardiopulmonary bypass and cardiac arrest, but the tumor on the free wall of the right ventricle trabeculae could not be completely resected. After surgery, the patient underwent chemotherapy for residual tumor, which is growing.
Collapse
Affiliation(s)
- Takuma Muraoka
- Department of Cardiovascular Surgery, Niigata Prefectural Shibata Hospital, Shibata, Japan
| | | | | |
Collapse
|
9
|
Yang CS, Zhang PL, Liu ZJ. Squamous cell lung cancer with bi-ventricular cardiac metastasis. J Nucl Cardiol 2022; 29:370-371. [PMID: 32596792 DOI: 10.1007/s12350-020-02253-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 05/26/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Chang-Sheng Yang
- Orthopedic and Soft Tissue Surgery Department, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China
| | - Pin-Liang Zhang
- Internal Medicine Department, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, Shandong, People's Republic of China
| | - Zeng-Jun Liu
- Internal Medicine Department, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, Shandong, People's Republic of China.
| |
Collapse
|
10
|
Cao J, Yang Y. 18F-FDG PET/CT detected recurrent renal cell carcinoma presenting with cardiac metastasis. J Nucl Cardiol 2021; 28:3085-3087. [PMID: 33977368 DOI: 10.1007/s12350-021-02652-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Jiahua Cao
- Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Yuhua Yang
- Department of PET/CT, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China.
| |
Collapse
|
11
|
Tang X, Zhou W, Huang D, Chen L, Zhang G. Anti-PD-1 Therapy-A Potential Treatment for Myocardial Metastasis From Nasopharyngeal Carcinoma: A Case Report. Front Immunol 2021; 12:688682. [PMID: 34804001 PMCID: PMC8602087 DOI: 10.3389/fimmu.2021.688682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 10/19/2021] [Indexed: 12/24/2022] Open
Abstract
Myocardial metastasis of nasopharyngeal carcinoma (NPC) is rarely reported in the literature. Some autopsy studies found metastases in more than 10% of cases with malignant neoplasm. However, patients are often diagnosed during the postmortem because myocardial metastasis is often asymptomatic, and its Cardiac complications tend to be severe and fatal. Patients with Cardiac metastases are often treated with chemotherapy or surgical intervention, although the prognosis is poor. Immunotherapy with anti-programmed cell death receptor-1 or ligand-1 (PD-1 or PD-L1) inhibitors has recently been reported to be therapeutically significant in multiple cancers, including melanoma, nonsmall cell lung cancer, and NPC, but the treatment of myocardial metastasis of NPC has not been reported. This study described the case of a 50-year-old male patient who presented initially with NPC and received radiotherapy as first-line therapy. For 20 years, he had recurrent Cardiac metastasis of NPC. The pathological examination suggested tPD-L1 expression. Therefore, off-label sintilimab (200 mg every 21 days) was administered. After 10 cycles of treatment, myocardial metastasis shrank and the enlarged mediastinal lymph nodes disappeared. This case report demonstrated that Cardiac metastasis of NPC expressing PD-L1 might have a sustained response to PD-L1 inhibitor-directed therapy.
Collapse
Affiliation(s)
- Xiaowan Tang
- Department of Hematology and Oncology, Wenzhou Medical affiliated Huangyan Hospital, The First People’s Hospital of Taizhou, Taizhou, China
| | - Weijun Zhou
- Department of Clinical Medicine, Second Clinical Medical College, Wenzhou Medical University, Wenzhou, China
| | - Danjiang Huang
- Division of Radiology, Wenzhou Medical affiliated Huangyan Hospital, The First People’s Hospital of Taizhou, Taizhou, China
| | - Lili Chen
- Department of Hematology and Oncology, Wenzhou Medical affiliated Huangyan Hospital, The First People’s Hospital of Taizhou, Taizhou, China
| | - Guangwen Zhang
- Department of Hematology and Oncology, Wenzhou Medical affiliated Huangyan Hospital, The First People’s Hospital of Taizhou, Taizhou, China
| |
Collapse
|
12
|
Tsuchiya J, Moriyama S, Manabe O, Amemiya M, Yokoyama K, Kimura K, Fujii Y, Tateishi U. What is this image? 2021 image 1 result : A rare case of right ventricular metastasis in renal cell carcinoma detected by thallium-201 scintigraphy. J Nucl Cardiol 2021; 28:1213-1215. [PMID: 34109504 DOI: 10.1007/s12350-021-02694-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Junichi Tsuchiya
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Shingo Moriyama
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Osamu Manabe
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan.
- Department of Radiology, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
| | - Miki Amemiya
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kota Yokoyama
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Koichiro Kimura
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| | - Yasuhisa Fujii
- Department of Radiology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Ukihide Tateishi
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan
| |
Collapse
|
13
|
Delabie P, Evrard D, Zouhry I, Ou P, Rouzet F, Benali K, Piekarski E. Squamous cell carcinoma of the tongue with cardiac metastasis on 18F-FDG PET/CT: A case report and literature review. Medicine (Baltimore) 2021; 100:e25529. [PMID: 33847677 PMCID: PMC8052045 DOI: 10.1097/md.0000000000025529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/25/2021] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION The most common malignancies metastasizing to the heart are cancers of the lung, breast, mesothelioma, melanoma, leukemia, and lymphoma. Cardiac metastasis from a tongue cancer is a rare finding and only a few cases have been reported previously in the literature. In this case report and literature review, we discuss the main clinical features of patients with cardiac metastases secondary to a tongue cancer and imaging modalities performed, especially the 18F-Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). PATIENT CONCERNS This is a case of a 39-year-old woman who in April 2018 was diagnosed with an invasive well differentiated squamous cell carcinoma of the movable tongue. She underwent a left hemiglossectomy followed by a revision of hemiglossectomy and ipsilateral selective neck lymph nodes dissection levels II to III because of pathological margins. An early inoperable clinical recurrence was diagnosed and she received radiochemotherapy with good clinical and metabolic response. She remained asymptomatic thereafter. DIAGNOSIS In January 2020, a pre-scheduled 18F-FDG PET/CT showed a diffuse cardiac involvement. In February 2020, a biopsy of the lesion revealed a metastatic squamous cell carcinoma. INTERVENTIONS She was deemed to not be a cardiac surgical candidate and treated by palliative chemotherapy: taxol-carboplatin associated with cetuximab then cetuximab alone because of adverse effects. A re-evaluation imaging performed in April 2020 evidenced a progression of the cardiac involvement, which led to switch chemotherapy by immunotherapy with nivolumab. OUTCOMES This patient had a very poor prognosis and succumbed to major heart failure 4 months after the diagnosis of cardiac metastasis. CONCLUSION In this case report, 18F-FDG PET/CT proved to be useful in detecting cardiac metastasis and changed the therapeutic management of the patient. It suggests that patients with tongue malignancies in a context of poor initial prognosis should be followed-up early by 18F-FDG PET/CT with HFLC diet to facilitate detection of recurrence.
Collapse
Affiliation(s)
- Pierre Delabie
- Department of Nuclear Medicine, Centre Hospitalier Universitaire Bichat
| | - Diane Evrard
- Department of Otorhinolaryngology and Head and Neck Surgery
| | | | - Phalla Ou
- Department of Radiology, Centre Hospitalier Universitaire Bichat, Assistance Publique – Hôpitaux de Paris, Inserm 1148, Université de Paris, Paris, France
| | - François Rouzet
- Department of Nuclear Medicine, Centre Hospitalier Universitaire Bichat
| | - Khadija Benali
- Department of Nuclear Medicine, Centre Hospitalier Universitaire Bichat
| | - Eve Piekarski
- Department of Nuclear Medicine, Centre Hospitalier Universitaire Bichat
| |
Collapse
|
14
|
Chan AT, Dinsfriend W, Kim J, Yum B, Sultana R, Klebanoff CA, Plodkowski A, Perez Johnston R, Ginsberg MS, Liu J, Kim RJ, Steingart R, Weinsaft JW. Risk stratification of cardiac metastases using late gadolinium enhancement cardiovascular magnetic resonance: prognostic impact of hypo-enhancement evidenced tumor avascularity. J Cardiovasc Magn Reson 2021; 23:42. [PMID: 33814005 PMCID: PMC8020547 DOI: 10.1186/s12968-021-00727-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 02/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) is widely used to identify cardiac neoplasms, for which diagnosis is predicated on enhancement stemming from lesion vascularity: Impact of contrast-enhancement pattern on clinical outcomes is unknown. The objective of this study was to determine whether cardiac metastasis (CMET) enhancement pattern on LGE-CMR impacts prognosis, with focus on heterogeneous lesion enhancement as a marker of tumor avascularity. METHODS Advanced (stage IV) systemic cancer patients with and without CMET matched (1:1) by cancer etiology underwent a standardized CMR protocol. CMET was identified via established LGE-CMR criteria based on lesion enhancement; enhancement pattern was further classified as heterogeneous (enhancing and non-enhancing components) or diffuse and assessed via quantitative (contrast-to-noise ratio (CNR); signal-to-noise ratio (SNR)) analyses. Embolic events and mortality were tested in relation to lesion location and contrast-enhancement pattern. RESULTS 224 patients were studied, including 112 patients with CMET and unaffected (CMET -) controls matched for systemic cancer etiology/stage. CMET enhancement pattern varied (53% heterogeneous, 47% diffuse). Quantitative analyses were consistent with lesion classification; CNR was higher and SNR lower in heterogeneously enhancing CMET (p < 0.001)-paralleled by larger size based on linear dimensions (p < 0.05). Contrast-enhancement pattern did not vary based on lesion location (p = NS). Embolic events were similar between patients with diffuse and heterogeneous lesions (p = NS) but varied by location: Patients with right-sided lesions had threefold more pulmonary emboli (20% vs. 6%, p = 0.02); those with left-sided lesions had lower rates equivalent to controls (4% vs. 5%, p = 1.00). Mortality was higher among patients with CMET (hazard ratio [HR] = 1.64 [CI 1.17-2.29], p = 0.004) compared to controls, but varied by contrast-enhancement pattern: Diffusely enhancing CMET had equivalent mortality to controls (p = 0.21) whereas prognosis was worse with heterogeneous CMET (p = 0.005) and more strongly predicted by heterogeneous enhancement (HR = 1.97 [CI 1.23-3.15], p = 0.005) than lesion size (HR = 1.11 per 10 cm [CI 0.53-2.33], p = 0.79). CONCLUSIONS Contrast-enhancement pattern and location of CMET on CMR impacts prognosis. Embolic events vary by CMET location, with likelihood of PE greatest with right-sided lesions. Heterogeneous enhancement-a marker of tumor avascularity on LGE-CMR-is a novel marker of increased mortality risk.
Collapse
Affiliation(s)
- Angel T Chan
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Pharmacological Sciences, Icahn School of Medicine At Mount Sinai, New York, NY, USA.
| | - William Dinsfriend
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jiwon Kim
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Brian Yum
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Razia Sultana
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | | | - Andrew Plodkowski
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rocio Perez Johnston
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michelle S Ginsberg
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jennifer Liu
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Raymond J Kim
- Duke Cardiovascular Magnetic Resonance Center, Durham, NC, USA
| | - Richard Steingart
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jonathan W Weinsaft
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
| |
Collapse
|
15
|
Yu IS, Funk G, Lin E, Kennecke HF. The Use of Peptide Receptor Radionuclide Therapy in Patients With Neuroendocrine Tumor Cardiac Metastases. Clin Nucl Med 2021; 46:e23-e26. [PMID: 33278176 DOI: 10.1097/rlu.0000000000003283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cardiac metastases are an infrequent site of metastasis in neuroendocrine tumors, and the treatment implications in the era of peptide receptor radionuclide therapy (PRRT) are unclear. Potential safety concerns exist regarding cardiac integrity and function in response to PRRT. We describe our institutional experience with 4 patients with well-differentiated, midgut neuroendocrine tumors with cardiac involvement detected on Ga-DOTATATE PET/CT scans who were treated with PRRT.
Collapse
Affiliation(s)
- Irene S Yu
- From the BC Cancer, Vancouver, British Columbia, Canada
| | - Gayle Funk
- Virginia Mason Medical Center, Seattle, WA
| | - Eugene Lin
- Virginia Mason Medical Center, Seattle, WA
| | | |
Collapse
|
16
|
Liu M, Armeni E, Navalkissoor S, Davar J, Sullivan L, Leigh C, O'Mahony LF, Hayes A, Mandair D, Chen J, Caplin M, Toumpanakis C. Cardiac Metastases in Patients with Neuroendocrine Tumours: Clinical Features, Therapy Outcomes, and Prognostic Implications. Neuroendocrinology 2021; 111:907-924. [PMID: 32717739 DOI: 10.1159/000510444] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/20/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cardiac metastases (CM) from neuroendocrine tumours (NET) are rare; however, with the introduction of new molecular imaging modalities, such as 68Ga-DOTATATE PET-CT for NET diagnosis and re-staging, they are now identified more frequently. This study presents a single-institution experience on the NET CM characteristics, management, and prognostic implications. METHODS Between January 1998 and January 2020, 25 NET patients with CM were treated in our unit. A retrospective review of electronic records was performed. Overall survival (OS) was assessed by the Kaplan-Meier method. Cox regression models were used to evaluate the association of various clinical variables with OS. RESULTS The median age in the NET CM cohort was 64 years, with small intestine being the most common primary (84%). Nearly half of the patients suffered either from shortness of breath (48%) or had palpitations (12%). Peptide receptor radionuclide therapy (PRRT) was applied in more than half of the patients (64%), who had an improved trend for a longer median OS compared to those patients who did not receive PRRT (76.0 vs. 14.0 months, p = 0.196). The multivariate analysis demonstrated that concomitant skeletal or pancreatic metastases, as well as N-terminal pro-B-type natriuretic peptide (NT pro-BNP) >2 × upper limit of normal (ULN), were independent poor prognosticators. CONCLUSIONS Clinical features of NET CM ranged from asymptomatic patients to heart failure. Concomitant bone or pancreatic metastases and NT pro-BNP levels >2 ULN predicted shorter survival time. PRRT serves as a feasible therapy with promising survival benefits; however, more data are needed.
Collapse
Affiliation(s)
- Man Liu
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
- Department of Gastroenterology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Eleni Armeni
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | | | - Joseph Davar
- Cardiology Department, Royal Free Hospital, London, United Kingdom
| | - Luke Sullivan
- Medical School, University College of London, London, United Kingdom
| | - Charlotte Leigh
- Medical School, University College of London, London, United Kingdom
| | | | - Aimee Hayes
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Dalvinder Mandair
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Jie Chen
- Department of Gastroenterology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Martyn Caplin
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Christos Toumpanakis
- Neuroendocrine Tumour Unit, Center for Gastroenterology, ENETS Centre of Excellence, Royal Free London NHS Foundation Trust, London, United Kingdom,
| |
Collapse
|
17
|
Nosrati A, Nabati M, Vahedi L, Shokri M. Invasion of poorly differentiated large-cell neuroendocrine tumor of the lung through right pulmonary veins into the left atrium: A very rare case report. J Clin Ultrasound 2020; 48:560-564. [PMID: 33031570 DOI: 10.1002/jcu.22844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 04/02/2020] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
Intracavitary cardiac metastasis is a rare manifestation of primary lung cancer which can be associated with a very poor prognosis. In this condition, the right chambers of the heart are more commonly involved and the invasion of the left atrium (LA) through the venous routes is highly exceptional. Poorly differentiated large-cell neuroendocrine tumors also include only 3% of all primary lung carcinomas which can have adverse outcomes. Therefore, in this report, a rare case of a 72-year-old male patient with poorly differentiated large-cell neuroendocrine carcinoma of the right lung spreading to the LA through the right pulmonary veins was described.
Collapse
Affiliation(s)
- Anahita Nosrati
- Imam Khomaini Hospital, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Nabati
- Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Laleh Vahedi
- Imam Khomaini Hospital, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mojtaba Shokri
- Fatemeh Zahra Hospital, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
18
|
Stefàno PL, Barletta G, Andrei V, Cerillo AG, Nesi G, Pilato G, Pradella S, Santi R, Del Bene MR. Cardiac Metastasis of Sacral Chordoma. Ann Thorac Surg 2020; 111:e319-e321. [PMID: 33129773 DOI: 10.1016/j.athoracsur.2020.07.093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 07/18/2020] [Accepted: 07/22/2020] [Indexed: 11/17/2022]
Abstract
Chordoma is a rare tumor, usually diagnosed when the disease is advanced. Despite its slow growth, it is locally aggressive and has a poor long-term prognosis. Surgery is the mainstay treatment. Although cardiac metastases are very rare, the heart is frequently involved in systemic neoplastic diseases. This report describes a typical case of metastatic chordoma: the age at first diagnosis, the site of the primary tumor, and the slow growth of the cardiac metastasis were all typical features. Surgical excision of the mass from the right ventricular outflow tract is described together with echocardiographic, radiologic, and histopathologic characteristics of the metastatic chordoma.
Collapse
Affiliation(s)
- Pier Luigi Stefàno
- Department of Cardiac Surgery, Careggi University Hospital, Florence, Italy
| | - Giuseppe Barletta
- Department of Diagnostic Cardiology, Careggi University Hospital, Florence, Italy.
| | - Valentina Andrei
- Department of Diagnostic Cardiology, Careggi University Hospital, Florence, Italy
| | | | - Gabriella Nesi
- Pathology Section, Department of Health Sciences, Careggi University Hospital, Florence, Italy
| | - Giuseppe Pilato
- Department of Diagnostic Cardiology, Careggi University Hospital, Florence, Italy
| | - Silvia Pradella
- Department of Radiodiagnostics, Careggi University Hospital, Florence, Italy
| | - Raffaella Santi
- Pathology Unit, Careggi University Hospital, Florence, Italy
| | | |
Collapse
|
19
|
Brennan AP, Newcomb A, Creati L, Mariani J. Metastatic Right Ventricular Liposarcoma. Heart Lung Circ 2020; 30:e55-e57. [PMID: 33032898 DOI: 10.1016/j.hlc.2020.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/25/2020] [Accepted: 08/31/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Anthony P Brennan
- Department of Cardiology, St Vincent's Hospital Melbourne, Vic, Australia.
| | - Andrew Newcomb
- Department of Cardiac Surgery, St Vincent's Hospital Melbourne, Vic, Australia
| | - Louise Creati
- Department of Cardiology, St Vincent's Hospital Melbourne, Vic, Australia
| | - Justin Mariani
- Department of Cardiology, St Vincent's Hospital Melbourne, Vic, Australia
| |
Collapse
|
20
|
Yang T, Li Y, Zhang HM, Wang HY, Song YH. Resection of Cardiac Pheochromocytoma With Cardiopulmonary Bypass. Ann Thorac Surg 2020; 111:e153-e155. [PMID: 32828749 DOI: 10.1016/j.athoracsur.2020.06.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 05/31/2020] [Accepted: 06/02/2020] [Indexed: 11/19/2022]
Abstract
We report a case of a 21-year-old man with a cardiac pheochromocytoma involving the right atrium and extending to the right ventricular inflow tract, which was diagnosed by somatostatin receptor scintigraphy. For the preoperative evaluation, we chose multiple methods of imaging to accurately describe the anatomic extent and location of the tumor and its surrounding tissues, which showed that no major coronary artery ran through the tumor. The tumor was resected with disease-free margins effectively and safely with the use of cardiopulmonary bypass and with cardiac arrest. The patient remained asymptomatic at the 3-month follow-up.
Collapse
Affiliation(s)
- Tao Yang
- Department of Cardiovascular Surgery, Fuwai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Yuan Li
- Department of Cardiovascular Surgery, Fuwai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Hui-Min Zhang
- Department of Hypertension, Fuwai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Hong-Yue Wang
- Department of Pathology, Fuwai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Yun-Hu Song
- Department of Cardiovascular Surgery, Fuwai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China.
| |
Collapse
|
21
|
Henkens A, Navarra E, De Beco G, El Khoury G. Minimally invasive robotic excision of a cardiac septal neuroendocrine metastasis. Multimed Man Cardiothorac Surg 2020; 2020. [PMID: 32520452 DOI: 10.1510/mmcts.2020.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We present a rare case of a myocardial neuroendocrine metastasis in a 45-year-old male patient. The tumor was localized on the left side of the interventricular septum. Complete surgical excision of the tumor was successfully performed robotically through a left atriotomy, using a transmitral approach. The patient's postoperative course was uneventful. A robotic mini-invasive approach is a safe and feasible alternative to conventional surgery and should be considered when the anatomy is suitable for a minimally invasive procedure.
Collapse
Affiliation(s)
- Arnaud Henkens
- The Cardiovascular and Thoracic Surgery Department, St Luc's Hospital, Catholic University of Louvain, 1200 Brussels, Belgium
| | - Emiliano Navarra
- The Cardiovascular and Thoracic Surgery Department, St Luc's Hospital, Catholic University of Louvain, 1200 Brussels, Belgium
| | - Geoffroy De Beco
- The Cardiovascular and Thoracic Surgery Department, St Luc's Hospital, Catholic University of Louvain, 1200 Brussels, Belgium
| | | |
Collapse
|
22
|
Abstract
We report an 86-year-old woman who was diagnosed with multiple myeloma (MM) and was receiving chemotherapy since the age of 82. A high echoic mass attached to the mitral valve was observed on transthoracic echocardiography 4 years after the treatment. The possibility of malignancy could not be ruled out, and hence, the mass was excised surgically. Pathologically, most of the mass consisted of calcified lesion without tumour tissue, and these findings were not inconsistent with calcified amorphous tumour (CAT). This case suggests that CAT may be associated with MM and has been reported after a thorough literature review.
Collapse
|
23
|
Parghane RV, Basu S. Large cardiac metastasis from pancreatic neuroendocrine tumor and response to peptide receptor radionuclide therapy with 177Lu-DOTATATE. J Nucl Cardiol 2020; 27:340-341. [PMID: 30151794 DOI: 10.1007/s12350-018-1426-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 08/16/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Rahul V Parghane
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Jerbai Wadia Road, Parel, Mumbai, 400 012, India
- Homi Bhabha National Institute, Mumbai, India
| | - Sandip Basu
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Jerbai Wadia Road, Parel, Mumbai, 400 012, India.
- Homi Bhabha National Institute, Mumbai, India.
| |
Collapse
|
24
|
Henderson BB, Chaubey A, Roth LM, Robboy SJ, Tarasidis G, Jones JR, Sundermann JM, Chou J, Craddock AL, Stevenson L, Friez MJ, Kincaid EH, Stevenson RE. Whole-Genome and Segmental Homozygosity Confirm Errors in Meiosis as Etiology of Struma Ovarii. Cytogenet Genome Res 2019; 160:2-10. [PMID: 31865307 DOI: 10.1159/000504908] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2019] [Indexed: 11/19/2022] Open
Abstract
Strumae ovarii are neoplasms composed of normal-appearing thyroid tissue that occur within the ovary and rarely spread to extraovarian sites. A unique case of struma ovarii with widespread dissemination detected 48 years after removal of a pelvic dermoid provided the opportunity to reexamine the molecular nature of this form of neoplasm. One tumor, from the heart, consisting of benign thyroid tissue was found to have whole-genome homozygosity. Another tumor from the right mandible composed of malignant-appearing thyroid tissue showed whole-genome homozygosity and a deletion of 7p, presumably the second hit that transformed it into a cancerous tumor. Specimens from 2 other cases of extraovarian struma confined to the abdomen and 8 of 9 cases of intraovarian struma showed genome-wide segmental homozygosity. These findings confirm errors in meiosis as the origin of struma ovarii. The histological and molecular findings further demonstrate that even when outside the ovary, strumae ovarii can behave nonaggressively until they receive a second hit, thereafter behaving like cancer.
Collapse
|
25
|
El Ghannudi S, Germain P, Averous G, Gangi A, Schindler TH, Imperiale A. PET/CMR: One More Step Toward Noninvasive Morphofunctional Diagnosis of Cardiac Malignancies. JACC Cardiovasc Imaging 2019; 13:1270-1275. [PMID: 31607659 DOI: 10.1016/j.jcmg.2019.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 11/16/2022]
Affiliation(s)
- Soraya El Ghannudi
- Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, Strasbourg, France; Radiology, University Hospitals of Strasbourg, Strasbourg, France; ICube, CNRS/Unistra, Strasbourg, France
| | - Philippe Germain
- Radiology, University Hospitals of Strasbourg, Strasbourg, France
| | - Gerlinde Averous
- Pathology, University Hospitals of Strasbourg, Strasbourg, France; Faculty of Medicine, FMTS, University of Strasbourg, Strasbourg
| | - Afshin Gangi
- Radiology, University Hospitals of Strasbourg, Strasbourg, France; Faculty of Medicine, FMTS, University of Strasbourg, Strasbourg
| | - Thomas H Schindler
- Mallinckrodt Institute of Radiology, Division of Nuclear Medicine, Washington University, St. Louis, Missouri
| | - Alessio Imperiale
- Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, Strasbourg, France; Faculty of Medicine, FMTS, University of Strasbourg, Strasbourg; Molecular Imaging-DRHIM, IPHC, UMR 7178, CNRS/Unistra, Strasbourg, France.
| |
Collapse
|
26
|
Abstract
RATIONALE High-stage endometrial carcinoma is an aggressive tumor with a high propensity for distant spread. However, metastases to the pericardium are rare in gynecological cancer, and are usually fatal. PATIENT CONCERNS A 69-year-old woman was diagnosed with endometrial carcinoma with pericardium metastasis. The symptoms at presentation were panic and shortness of breath. DIAGNOSES The cytologic examination of pericardial fluid obtained by pericardiocentesis confirmed metastasis. INTERVENTIONS In addition to cisplatin instilled into the pericardial space, for systemic chemotherapy, we chose that gemcitabine and lobaplatin regimen be preferred. OUTCOMES The patient has been participating in telephone follow-up for 8 months and has generally remained in a good condition. LESSONS Endometrial carcinoma can have pericardial metastases. When this happens, we recommend ultrasound-guided pericardial puncture and the pericardial injection of cisplatin, in combination with systemic chemotherapy that consists of gemcitabine and lobaplatin.
Collapse
Affiliation(s)
- Guang Liu
- Department of Cardiology, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital
| | | | - Ze Li
- Department of Emergency, Hebei Medical University Second Affiliated Hospital, Shijiazhuang, Hebei, P. R. China
| | | | - Ning Zhang
- Department of Cardiology, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital
| | - Jinli Zhang
- Department of Cardiology, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital
| |
Collapse
|
27
|
Liu Y. Focal mass-like cardiac uptake on oncologic FDG PET/CT: Real lesion or atypical pattern of physiologic uptake? J Nucl Cardiol 2019; 26:1205-1211. [PMID: 30443752 DOI: 10.1007/s12350-018-01524-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 11/06/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cardiac uptake on oncologic FDG PET/CT can be unpredictable. Focal or mass-like cardiac uptake not confined to normal pattern is a real challenge for interpretation due to great variability in physiologic uptake and rarity of either primary or metastatic cardiac neoplasms. METHODS AND RESULTS Eight patients with suspicious mass-like cardiac uptake on oncologic FDG PET/CT were retrospectively analyzed with correlation to cardiac workups including contrast CT, echocardiography, and repeat PET/CT. Four patients had real cardiac lesions or metastases. Focal uptake was benign and might represent papillary muscle in the other four. SUVmax ratio between the cardiac focus and surrounding background cardiac uptake was statistically higher in the true-positive group than that in the false-positive group. In addition, the patients with true-positive cardiac uptake had more diffuse distant metastases compared to those with false-positive cardiac uptake. CONCLUSIONS Focal suspicious cardiac uptake on oncology FDG PET/CT warranted further evaluation. SUVmax ratio between the cardiac focus and surrounding background cardiac uptake and status of distant metastases might help to differentiate malignant from benign nature of the focal cardiac uptake on FDG PET/CT. Focal uptake of the right ventricle on oncologic FDG PET/CT is more likely suggestive of a neoplasm.
Collapse
Affiliation(s)
- Yiyan Liu
- Nuclear Medicine Service, Department of Radiology, New Jersey Medical School, Rutgers University, H-141, 150 Bergen Street, Newark, NJ, 07103, USA.
| |
Collapse
|
28
|
Wang S, Zheng L, Yang HB. [A case of misdiagnose of non-gestational choriocarcinoma metastasis to left atrium]. Zhonghua Xin Xue Guan Bing Za Zhi 2019; 47:575-576. [PMID: 31366001 DOI: 10.3760/cma.j.issn.0253-3758.2019.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- S Wang
- Department of Cardiology, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450000, China
| | | | | |
Collapse
|
29
|
Lattuada S, Saggia C, Biaggi G, Santagostino A, Forti G, Manachino D, Bellan L, Pollo MC, Alabiso O. Pericardial Metastases in a Long-Surviving Patient with Sigmoid Carcinoma. Tumori 2019; 91:101-2. [PMID: 15850017 DOI: 10.1177/030089160509100122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cardiac metastases are rare in patients affected by colorectal cancer. This is the case of a woman who underwent a colon resection because of a metastatic sigmoid carcinoma, that survived for more than 6 years and died for malignant pericardial effusion.
Collapse
Affiliation(s)
- Sara Lattuada
- Unità Operativa di Oncologia Medica, Ospedale S Andrea, Vercelli, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Cortese F, Di Marino S, Portulano V, Scicchitano P, Ciccone MM, Calculli G. [Electrocardiographic changes associated with cardiac metastasis]. G Ital Cardiol (Rome) 2019; 20:429-430. [PMID: 31320764 DOI: 10.1714/3190.31686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
| | - Serena Di Marino
- 163794>2Unità di Cardiologia, P.O. "Valle d'Itria", Martina Franca (TA)
| | | | | | - Marco Matteo Ciccone
- Unità di Cardiologia, Dipartimento d'Emergenza e dei Trapianti d'Organo, Policlinico di Bari, Bari
| | | |
Collapse
|
31
|
|
32
|
Affiliation(s)
- Houssein Safa
- University of Texas M.D. Anderson Cancer Center, Houston, TX
| | | |
Collapse
|
33
|
Gesu E, Gelpi G, Piconi S, Righi I, Andrisani MC, Garanzini E, Vespro V, Costantino G. Fever, edema, and shortness of breath: the Scrhödinger's cat paradox displayed on pericardium. Intern Emerg Med 2019; 14:103-108. [PMID: 29627877 DOI: 10.1007/s11739-018-1850-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 03/30/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Elisa Gesu
- UOC Pronto Soccorso e Medicina d'Urgenza, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
| | - Guido Gelpi
- Dipartimento di Chirurgia Cardiovascolare, ASST Fatebenefratelli Sacco, Università degli Studi di Milano, Milan, Italy
| | - Stefania Piconi
- Dipartimento di Malattie Infettive, ASST Fatebenefratelli Sacco, Università degli Studi di Milano, Milan, Italy
| | - Ilaria Righi
- Dipartimento di Chirurgia Toracica e Trapianti di Polmone, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Maria Carmela Andrisani
- Dipartimento di Diagnostica per Immagini, UOC di Radiologia, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Enrico Garanzini
- Dipartimento di Diagnostica per Immagini, UOC di Radiologia, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Valentina Vespro
- Dipartimento di Diagnostica per Immagini, UOC di Radiologia, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Giorgio Costantino
- Dipartimento di Medicina Interna, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
34
|
Abstract
INTRODUCTION Multiple cardiac metastases from nonsmall-cell lung cancer are extremely rare. Multiple cardiac metastases detected by F-fluorodeoxyglucose positron-emission tomography/computed tomography (F-FDG PET/CT) have not been previously reported. PATIENT CONCERNS A 53-year-old man was admitted to the hospital with left back pain for 1 month. DIAGNOSES A contrast-enhanced computed tomography (CECT) scan showed a moderately enhancing mass with a necrotic area in the upper left lobe of the lung and a filling defect in the interventricular septum. Two-dimensional transthoracic echocardiography identified a mass attaching to the endocardial surface of interventricular septum. F-FDG PET/CT showed multiple intense F-FDG uptakes in the cardiac region. Nonsmall-cell lung cancer was confirmed by histopathologic examination of the mass in the upper left lobe of the lung. INTERVENTION The patient was treated with Gemcitabine chemotherapy. OUTCOMES After 18 months of follow-up, the patient achieved stable disease status according to the Response Evaluation Criteria In Solid Tumors guidelines. LESSONS Our case demonstrates thatF-FDG PET/CT is a sensitive and feasible imaging modality to diagnosis multiple cardiac metastases.
Collapse
|
35
|
Zakhartseva LM, Zakharova VP, Shatrova KM, Chitaeva GE, Vitovsky RM. Metastatic cardiac tumors: literature review and own observation of testicular tumor metastasis in the right ventricle of the heart. Exp Oncol 2018; 40:336-342. [PMID: 30593757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Tumors of the heart are uncommon and usually benign (in 93% cases myxomas are observed). More often secondary, metastatic tumors are detected in the heart, as a rule, at pronounced progression of the malignant neoplasm with multiple lesions of other internal organs (lung, pleura, liver, etc.). Literature review on cardiac metastases of different tumors is given. CASE REPORT Own observation of a young man with rare single metastasis of malignant testicular germ cell tumor with predominance of embryonic carcinoma in the right ventricle of the heart is presented; the primary tumor was detected after metastasis revealing. The diagnostic algorithm using routine histological study supplemented with immunohistochemistry, including detection of cytokeratin pan, cytokeratin 5/6, cytokeratin 7, CD30, OCT4, TTF-1, hCG, and AFP markers expression, is described.
Collapse
Affiliation(s)
| | - V P Zakharova
- Amosov National Institute of Cardiovascular Surgery, Kyiv 02000, Ukraine
| | - K M Shatrova
- Kyiv City Clinical Cancer Center, Kyiv 03115, Ukraine
| | - G E Chitaeva
- Bogomolets National Medical University, Kyiv 03115, Ukraine
| | - R M Vitovsky
- Amosov National Institute of Cardiovascular Surgery, Kyiv 02000, Ukraine
| |
Collapse
|
36
|
Konishi K, Araya J, Nagabuchi M, Sakamoto T, Murai D. [A Case of a Breast Cancer Patient with Cardiac Metastasis]. Gan To Kagaku Ryoho 2018; 45:1763-1765. [PMID: 30587737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The patient was a 65-year-old woman who was diagnosed with Stage III A triple-negative breast cancer(T2N2aM0)at the age of 63. AC chemotherapy(3 months)followed by paclitaxel plus bevacizumab(4 months)was administered as neoadjuvant chemotherapy. After chemotherapy, she underwent mastectomy and lymph node dissection. Pathological examination revealed a partial response. After surgery, radiotherapy with a radiation dose of 50 Gy was applied to the chest wall and supraclavicular lymph node. Multiple pulmonary metastases and mediastinal lymph node metastases were diagnosed 23 months after initial treatment, and she was treated with S-1 administration. Two months after S-1 treatment, the PET-CT showed metastasis in the right atrium. Since there were no cardiac symptoms, S-1 treatment was continued without cardiovascular treatment. However, the mediastinal lymph node metastasis progressed; and therefore, S-1 administration was stopped and chemotherapy with eribulin was initiated. Brain metastasis was diagnosed at the same time and treated with a gamma knife. Although chemotherapy with eribulin was continued, the patient died 33 months after initial treatment owing to the brain metastasis. The cardiac metastasis did not progress during chemotherapy with eribulin. There was no sign of heart failure or arrhythmia during the treatment.
Collapse
|
37
|
Fujio H, Otsuki N, Horichi Y, Yanagisawa S, Nishio M, Teshima M, Shinomiya H, Hashikawa K, Nibu KI. Cardiac metastasis in a living patient with oral cancer. Auris Nasus Larynx 2018; 46:902-906. [PMID: 30470634 DOI: 10.1016/j.anl.2018.10.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 10/23/2018] [Accepted: 10/29/2018] [Indexed: 11/19/2022]
Abstract
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.
Collapse
Affiliation(s)
- Hisami Fujio
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naoki Otsuki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Yuto Horichi
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shungaku Yanagisawa
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mari Nishio
- Division of Pathology, Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masanori Teshima
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazunobu Hashikawa
- Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
38
|
Mao YH, Deng YB, Liu YN, Wei X, Bi XJ, Tang QY, Wang YB, Wang XY. Contrast Echocardiographic Perfusion Imaging in Clinical Decision-Making for Cardiac Masses in Patients With a History of Extracardiac Malignant Tumor. JACC Cardiovasc Imaging 2018; 12:754-756. [PMID: 30448137 DOI: 10.1016/j.jcmg.2018.08.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/24/2018] [Accepted: 08/30/2018] [Indexed: 11/16/2022]
|
39
|
Abstract
RATIONALE Merkel cell carcinoma (MCC) is an aggressive, rare neuroendocrine skin cancer. MCC metastasis to the heart is exceedingly rare and gastric metastases from MCC have rarely been reported. PATIENT CONCERNS We described the case of an 82-year-old man diagnosed with recurrent MCC with cardiac and gastric metastasis who presented with poor oral intake and severe weight loss. The patient was diagnosed with MCC 3 years ago and treated with surgical resection and radiation. INTERVENTIONS We performed stomach biopsy in edematous lesion. And fluoroscopy and ultrasound guided biopsy of the cardiac mass was performed. DIAGNOSES MCC with synchronous metastases to the heart and stomach. OUTCOMES The primary lesion had complete resolution and the patient remained disease free on regular follow-up every 6 months for 2 and half years. After MCC recurred, palliative anti-cancer therapy was considered but could not be performed due to the patient's poor performance status involved elderly, combined recurrent pneumonia. LESSONS To our best knowledge, this is the first report of synchronous cardiac and gastric metastasis from cutaneous MCC worldwide. Although uncommon, MCC should be considered in clinical cases of synchronous metastasis.
Collapse
Affiliation(s)
| | | | - Hee Sung Kim
- Department of Pathology, Chung-Ang University College of Medicine, Seoul, South Korea
| | | | | | | |
Collapse
|
40
|
Conroy M, Greally M, MacEneaney O, O’Keane C, McCaffrey J. Sarcomatoid Carcinoma of the Prostate Presenting in a 44 Year Old. Ir Med J 2018; 111:825. [PMID: 30556673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We present the case of a 44-year-old man diagnosed with metastatic sarcomatoid carcinoma of the prostate. The pathogenesis and optimal treatment of this rare and aggressive subtype of prostate cancer are not fully clear. The patient was managed using a multimodality approach of chemotherapy, hormonal blockade and radiation therapy, with palliative intent.
Collapse
Affiliation(s)
- M Conroy
- Department of Medical Oncology, Mater Misericordiae University Hospital, Dublin
| | - M Greally
- Department of Medical Oncology, Mater Misericordiae University Hospital, Dublin
| | - O MacEneaney
- Department of Pathology, Mater Misericordiae University Hospital, Dublin
| | - C O’Keane
- Department of Pathology, Mater Misericordiae University Hospital, Dublin
| | - J McCaffrey
- Department of Medical Oncology, Mater Misericordiae University Hospital, Dublin
| |
Collapse
|
41
|
Kim DH, Cho E, Cho SB, Choi SK, Kim S, Yu J, Koh YI, Sim DW, Jun CH. Complete response of hepatocellular carcinoma with right atrium and pulmonary metastases treated by combined treatments (a possible treatment effect of natural killer cell): A case report and literature review. Medicine (Baltimore) 2018; 97:e12866. [PMID: 30334999 PMCID: PMC6211840 DOI: 10.1097/md.0000000000012866] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
RATIONALE Hepatocellular carcinomas (HCCs) with metastases to the right atrium (RA) and lungs are rare, with a poor prognosis. Furthermore, the treatment outcomes in patients with advanced HCCs remain unsatisfactory. PATIENT CONCERNS A 46-year-old man presented to our hospital for dyspnea on exertion and abdominal pain. DIAGNOSES HCC and extra-hepatic metastases to the lung and RA. INTERVENTIONS Multidisciplinary treatment including radiotherapy (RT), transarterial chemoembolization (TACE), and sorafenib. During a follow-up evaluation computed tomography, he experienced a radio-contrast-induced anaphylaxis. After the event, treatment such as RT, TACE, and sorafenib were continued. OUTCOMES His tumor burden decreased, finally leading to a complete response as per the modified Response Evaluation Criteria in Solid Tumors. The patient is still alive, 30 months after the episode. Subsequent blood tests showed increased natural killer (NK) cell activity, which was significantly higher than that seen in other age-matched HCC patients with an identical stage of the tumor, receiving sorafenib. This suggests that the increase in NK cells induced by anaphylaxis influenced the tumor burden. LESSONS We report here a rare case of long-term survival of an HCC patient with multiple metastases treated with multidisciplinary modalities, in which high NK cell activity was observed after a radio-contrast-induced anaphylactic reaction during follow-up investigations.
Collapse
Affiliation(s)
| | | | | | | | | | - Jieun Yu
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, South Korea
| | - Young-Il Koh
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, South Korea
| | - Da Woon Sim
- Division of Allergy, Asthma, and Clinical Immunology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, South Korea
| | | |
Collapse
|
42
|
Watanabe I, Kanauchi N, Watanabe H. [A Case of Myocardial and Cutaneous Metastases of Squamous Cell Lung Cancer Post Left Pneumonectomy and Radical Surgery for Cutaneous Metastasis during Nivolumab Therapy]. Gan To Kagaku Ryoho 2018; 45:1441-1444. [PMID: 30382041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Concomitant myocardial and cutaneous metastases of squamous cell lung cancer after left pneumonectomy are very rare. Although nivolumab is used as a standard second-line chemotherapy for non-small cell lung cancer(NSCLC), its efficacy for concomitant myocardial and cutaneous metastases remains unclear. CASE A 66-year-old man with no chief complaints was diagnosed with myocardial metastasis by CT scan. The patient underwent radical left pneumonectomy for squamous cell lung cancer 12 months previously and had rejected adjuvant chemotherapy with pT2aN1M0- II B(7th edition). A skin lesion in the left side of the neck was diagnosed as cutaneous metastasis by cytological examination. First-line treatment with cisplatin plus gemcitabine was administered; it was then replaced with nivolumab as a second-line chemotherapy after the progression of the disease due to myocardial metastasis. Fortunately, after 5 courses of nivolumab, there was a reduction in the cutaneous metastasis, which allowed complete resection, and reduction in the volume of myocardial metastasis. The patient is alive 30 months after left pneumonectomy and 18 months after the diagnosis of relapse. Nivolumab treatment is on-going. CONCLUSION Complete resection of a cutaneous metastasis of squamous cell lung cancer and a reduction in the volume of myocardial metastasis were achieved following nivolumab treatment. Thus, nivolumab is a useful chemotherapy for concomitant cutaneous and myocardial metastases of squamous cell lung cancer.
Collapse
Affiliation(s)
- Isamu Watanabe
- Dept. of General Thoracic Surgery, Nihonkai General Hospital
| | | | | |
Collapse
|
43
|
Sullivan PJ, Fasina OO, BVSc ACC. Bilateral Malignant Seminoma With Ventricular Metastasis in a Bald Eagle ( Haliaeetus leucocephalus). J Avian Med Surg 2018; 32:240-245. [PMID: 30204011 DOI: 10.1647/2017-287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 30-year-old bald eagle ( Haliaeetus leucocephalus) was presented with a history of hyporexia and lethargy. Results of initial hematologic testing, biochemical analysis, and fecal examination were unremarkable, and clinical signs did not resolve with supportive care and management changes. Results of echocardiography, based on auscultation of a murmur, and coelomic endoscopy, based on the presence of a soft tissue opacity on radiographs, as well as an aspergillosis panel were largely unsuccessful in determining a definitive diagnosis. Euthanasia was performed after the eagle did not recover from anesthesia after endoscopy. Necropsy results demonstrated bilateral testicular seminomas with metastases to the ventriculus. This case demonstrates an abnormal metastasis of a common reproductive tumor in an avian species.
Collapse
|
44
|
Kaplin AW, Antinori CH, Slotman GJ. Cardiac Metastases from Squamous Cell Carcinoma of the Base of Tongue in a 70-Year-Old Female Six Years Disease-Free from the Primary Tumor. Am Surg 2018; 84:e290-e291. [PMID: 30842003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
|
45
|
Sacco KA, Stancampiano FF. Metastatic Carcinoid Taken to Heart. Mayo Clin Proc 2018; 93:1152. [PMID: 30077209 DOI: 10.1016/j.mayocp.2018.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 06/27/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Keith A Sacco
- Department of Medicine and Department of Radiology, Mayo Clinic, Jacksonville, FL.
| | | |
Collapse
|
46
|
Oyakawa T, Muraoka N, Iida K, Kusuhara M, Naito T. A Patient with a Massive Single Cardiac Metastasis of Lung Adenocarcinoma, Diagnosed via a Biopsy. Intern Med 2018; 57:1637-1640. [PMID: 29321403 PMCID: PMC6028669 DOI: 10.2169/internalmedicine.9893-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A patient with a history of lung adenocarcinoma was admitted because of palpitation. Transthoracic echocardiogram revealed a mass (74×42 mm) in the right ventricle. Computed tomography showed a tumor lesion in the right ventricular cavity but no other distant metastasis. Coronary angiography revealed well-developed small branches to the tumor. After right heart catheterization, a pathological analysis of a tumor biopsy demonstrated adenocarcinoma. We diagnosed the patient with right ventricular metastasis of lung cancer. With large cardiac metastasis, a tumor biopsy with a right heart catheter may help obtain a pathological diagnosis and also serve as a re-biopsy to confirm the gene mutation status.
Collapse
Affiliation(s)
| | - Nao Muraoka
- Division of Cardiology, Shizuoka Cancer Center, Japan
| | - Kei Iida
- Division of Cardiology, Shizuoka Cancer Center, Japan
| | | | - Tateaki Naito
- Division of Thoracic Oncology, Shizuoka Cancer Center, Japan
| |
Collapse
|
47
|
Karabag T, Arslan C, Yakısan T, Vatan A, Sak D. Metastatic adenocarcinoma involving the right ventricle and pulmonary artery leading to right heart failure: case report. SAO PAULO MED J 2018; 136:262-265. [PMID: 28562738 PMCID: PMC9907742 DOI: 10.1590/1516-3180.2016.0351280117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 01/28/2017] [Indexed: 11/21/2022] Open
Abstract
CONTEXT Obstruction of the right ventricular outflow tract due to metastatic disease is rare. Clinical recognition of cardiac metastatic tumors is rare and continues to present a diagnostic and therapeutic challenge. CASE REPORT We present the case of a patient who had severe respiratory insufficiency and whose clinical examinations revealed a giant tumor mass extending from the right ventricle to the pulmonary artery. We discuss the diagnostic and therapeutic options. CONCLUSION In patients presenting with acute right heart failure, right ventricular masses should be kept in mind. Transthoracic echocardiography appears to be the most easily available, noninvasive, cost-effective and useful technique in making the differential diagnosis.
Collapse
Affiliation(s)
- Turgut Karabag
- MD. Associate Professor, Department of Cardiology, Istanbul Education and Research Hospital, Istanbul, Turkey.
| | - Caner Arslan
- MD. Associate Professor, Department of Cardiovascular Surgery, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.
| | - Turab Yakısan
- MD. Resident Physician, Department of Cardiology, Istanbul Mehmet Akif Ersoy Education and Research Hospital, Istanbul, Turkey.
| | - Aziz Vatan
- MD. Resident Physician, Department of Emergency Medicine, Istanbul Education and Research Hospital, Istanbul, Turkey.
| | - Duygu Sak
- MD. Resident Physician, Department of Internal Medicine, Istanbul Education and Research Hospital, Istanbul, Turkey.
| |
Collapse
|
48
|
Masci G, Magagnoli M, Grimaldi A, Covini G, Carnaghi C, Rimassa L, Santoro A. Metastasis of Hepatocellular Carcinoma to the Heart: A Case Report and Review of the Literature. Tumori 2018; 90:345-7. [PMID: 15315319 DOI: 10.1177/030089160409000317] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hepatocellular carcinoma (HCC) with extension or metastasis to the right atrium is an uncommon form of cardiac malignancy. This report describes a rare case of right intraventricular metastasis from HCC in a patient who had undergone a partial hepatectomy for HCC more than two years earlier. Open heart surgery was performed and the mass was partially excised. Symptoms (dyspnea, edema of the lower extremities, palpitations) improved after surgery. Two months later a recurrence of the ventricular mass was observed. Systemic chemotherapy with cisplatin and doxorubicin resulted in significant tumor reduction. The patient died of progressive hepatic failure six months later. In addition to this case report, a review of the literature on heart involvement from HCC is presented.
Collapse
Affiliation(s)
- Giovanna Masci
- Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Rozzano, Milan, Italy.
| | | | | | | | | | | | | |
Collapse
|
49
|
Abstract
Malignant fibrous histiocytoma metastasizing to the left ventricle is an uncommon form of cardiac malignancy. This report describes a rare case of left ventricular metastases from a malignant fibrous histiocytoma of the posterior compartment of the right thigh, recurring five years after treatment with surgery, hyperthermic perfusion of the limb and radiotherapy. As the patient presented symptoms of cardiac tamponade, open heart surgery was performed through a median sternotomy; however, the tumor was not resectable and only a biopsy was performed. A partial response was obtained with standard and high-dose chemotherapy with peripheral blood progenitor cell transplantation. The response continued to improve with immunotherapy. The patient returned to normal physical activity. He died four years later due to a ventricular arrhythmia.
Collapse
Affiliation(s)
- Francesco Recchia
- Unità operativa di Oncologia, Ospedale Civile di Avezzano, AQ, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Ali U, Halian A, Khan N, Khwaja SB. Metastatic Cardiac Melanoma With T-Wave Inversions. J Ayub Med Coll Abbottabad 2018; 30:278-279. [PMID: 29938434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A woman in her 70's with a background of ocular malignant melanoma treated more than a decade ago was admitted to hospital with symptoms of dysphagia and exertional shortness of breath. Routine ECG showed a grossly abnormal ECG with T wave inversion in inferolateral leads and some anterior leads. Consequently, echocardiography and CT demonstrated the presence of a large pericardial tumour which on biopsy was found to be metastatic melanoma. Patient was treated with palliative radiotherapy with only temporary initial benefit.
Collapse
|