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The prevalence of transplacental viral infections as a cause of spontaneous abortion should be considered high in the placenta with villitis. Thus, this study highlights the need for developing diagnostic tests to clarify the aetiology of abortion and foetal loss.

Cardiac metastasis of germ cell tumors is extremely rare, particularly in females. We report a case of a 26-year-old previously healthy woman who presented with a 5-month history of abdominal pain, weight loss, fever, generalized lymphadenopathy, and acanthosis nigricans. Biopsy of cervical lymph nodes revealed a poorly differentiated neoplasm. Immunohistochemical staining was positive for alpha-fetoprotein suggesting the diagnosis of a germ cell tumor. During the investigation, the patient developed heart failure and a mass attached to the right ventricle was detected by the echocardiogram. In a few days, she developed multiple organ failure and died. Post-mortem examination revealed a malignant mixed germ cell tumor of the right ovary with extensive hematogenic and lymphatic dissemination, a polypoid mass attached to the right ventricle, emboli in the endocardial and epicardial vessels, and infiltration surrounding the coronary arteries. To the best of our knowledge this is the third report of grossly visible heart metastases from a yolk sac tumor in a female patient. A summary of all published cases of germ cell tumors with cardiac metastasis over the last 20 years is also presented.

A 39-year-old woman was admitted with dysarthria, left facio-brachio-crural paresis, and increased frontotemporal headache. She had undergone heart transplantation due to end-stage Chagas heart disease 4 months previously and was on immunosuppression therapy. MRI of the brain demonstrated a right cortico-subcortical frontoparietal lesion with mass effect and heterogeneous enhancement with gadolinium (figure 1). Stereotaxic brain biopsy demonstrated nests of amastigotes and assay for Trypanosoma cruzi confirmed the diagnosis (figure 2).1 Therapy with benznidazole was successful. This case illustrates that T cruzi infection reactivation may occur and requires early diagnosis and treatment.

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