Tumor metastático espinocelular de cérvix uterino para coração: diagnóstico ante mortem

Abstract

Sixty-three-year-old woman with a past medical history of uterine cancer and complaint of fatigue and dyspnea on mild exertion. Physical examination revealed hypertension and rales at lung bases. A transthoracic echocardiogram showed a mass with reduced mobility in the right ventricle. The patient was taken to surgery during which a mass involving the anterior wall of the pulmonary artery, tricuspid valve, right atrium, and posterior wall of the right ventricle was found. The pulmonary artery and the right ventricle were reconstructed with a bovine pericardium patch and the tricuspid valve was replaced by a number-31 biological prosthesis. The pathological examination revealed metastasis of squamous cells with well-differentiated infiltrative areas. The patient was discharged one month after surgery. Four months later, however, she was readmitted to hospital in terminal stage, confirming the guarded prognosis of the disease at this stage. Cardiac metastases from squamous cell carcinoma of the uterine cervix are uncommon findings; however their diagnosis and successful surgical treatment are even rarer.Among the several different types of neoplasia that may affect the heart, secondary tumors are 40 times more common than primary tumors 1 and the most varied types of tumors may attack the heart The main tumors to metastasize to the heart are, in descending order, melanoma, leukemias, bronchogenic tumors, and breast cancer. Metastasis from squamous cell carcinoma of the uterine cervix is one of the less frequent metastases, occurring in 5.9% of the cases 2 .The metastatic squamous cell carcinoma of the uterine cervix is one of the less common secondary tumors and it is difficult to be diagnosed; most of them are only found in autopsies. When symptomatic, it may cause arrhythmias, and may lead to complete heart block, pericardial tamponade, congestion due to myocardial replacement by tumor cells, intracardiac obstructions, myocardial infarction, peripheral embolism, and others. True myocardial infiltration or a simple intracardiac extension of the vena cava or of the pulmonary vein may occur 3 .In the present case, we report the in vivo diagnosis and the importance of considering cardiac metastasis in carcinoma of the uterine cervix, since this is a common disease among women and the symptoms of metastases are unspecific. Case ReportFemale, 63 years of age, born in the State of Santa Catarina, Brazil, was referred to the Department of Cardiovascular Surgery of a University Hospital in the city of Curitiba with a previous diagnosis of cardiac tumor and past medical history of uterine cervix cancer diagnosed at the age of 30 after three miscarriages, and treated with surgical resection (conization), 35 sessions of radiation therapy, and 3 sessions of chemotherapy.Two months prior to the hospitalization for evaluation of the cardiac tumor mass, the patient underwent angioplasty, and the obstruction of the anterior descending coronary artery was reduced by 80%. At admission she complained of fatigue and dyspnea on mild ...

Solitary cardiac metastasis of uterine cervical cancer with antemortem diagnosis: A case report and literature review

“…3 ) ( 1 , 6 , 10 – 24 ). The number of cases showing solitary metastasis to the heart, as in the present case, is even smaller; with only nine cases reported to date ( 6 , 10 , 14 , 16 – 18 , 22 – 24 ). The clinical stage at the time of initial diagnosis varied widely among the case reports published in the literature, ranging from stage I to IV ( 1 , 6 , 10 – 24 ).…”

Cardiac metastasis in cervical cancer

“…However, in the presence of an obstructive mass, resection may be helpful in managing invasive and non-invasive tumours. 15 …”