An enlarging pacemaker pocket: A case report of a plasmablastic lymphoma arising as a primary tumor around a cardiac pacemaker and systematic literature review of various malignancies arising at the pacemaker pocket

Zarifi, Ceyda; Deutsch, Steven; Dullet, Navjit; Mukherjee, Kishore; Mukherjee, Ashis K.; Abubaker, Firas

doi:10.1016/j.jccase.2017.09.006

Cited by 9 publications

(33 citation statements)

References 17 publications

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“…Based on the tissue sampling and the PET-CT images, the multidisciplinary oncology team decided that the most likely primary origin of the metastasis was the tumour in the left lung. There are case reports and small case series describing metastatic lesions of melanoma, 3 malignant lesions in the proximity of breast carcinoma, 4–6 sarcoma, 7 , 8 rhabdomyosarcoma, 9 cutaneous leiomyosarcoma , 10 squamous cell and basocellular carcinoma of the skin, 11 , 12 non-Hodgkin lymphoma, 13 plasmablastic lymphoma , 14 plasmacytoma, 15 and multiple myeloma. 16…”

Section: Discussionmentioning

confidence: 99%

An unexpected cause of a swollen pacemaker pocket: a case report

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Vanheste

Cuypers

et al. 2022

European Heart Journal - Case Reports

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Background A complication originating from the pacemaker pocket after device implantation can most often be explained by a post-operative pocket haematoma, or, less frequently, by a pocket infection. Both conditions need immediate assessment, dedicated treatment, and specialized follow-up. In rare cases, however, a swollen pacemaker pocket has an alternative diagnosis, which is exemplified by the following case. Case summary A 70-year-old male patient had a-specific symptoms of fatigue, dyspnoea, and coughing for some weeks. He also noted an evident, new swelling of his pacemaker pocket several months after pacemaker implantation, a procedure that was performed in a high-volume center and without any complication. Ultrasound imaging of the pocket suggested the presence of a soft tissue mass with increased vascularity, rather than a fluid collection or a late organized haematoma. Ultrasound-guided biopsy of the mass was obtained for histopathology analysis and revealed a well-differentiated invasive squamous cell carcinoma. Additional PET-CT imaging demonstrated multiple fluorodeoxyglucose-avid hotspots: a voluminous lesion in the left lung hilum, smaller lesions in the liver, some mediastinal lymph nodes, several bone lesions, and a large mass surrounding the pacemaker. The multidisciplinary oncologic specialty team concluded that the patient had an aggressive metastatic lung carcinoma. The patient refused to undergo further treatment and died 1.5 months after diagnosis. Discussion To the best of our knowledge, we did not find any earlier reports of a squamous cell carcinoma of the lung spreading to a pacemaker pocket. Presentation of a primary tumour or a metastasis in a pacemaker pocket is extremely rare. Ultrasound imaging with ultrasound-guided biopsy is a fast and reliable method to sample the tissue and to obtain a reliable diagnosis.

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Section: Discussionmentioning

confidence: 99%

An unexpected cause of a swollen pacemaker pocket: a case report

Popelier

Vanheste

Cuypers

et al. 2022

European Heart Journal - Case Reports

View full text Add to dashboard Cite

show abstract

“…12 Multiple theories have been proposed regarding the potential oncogenicity of pacemakers, including chronic inflammation from device pockets leading to development of lymphoma cells. 7,11 Of all case reports of malignancy associated with CIEDs, there are only 4 previously noted cases of lymphoma. Our first case seems to be the fifth lymphoma to be reported.…”

Section: Discussionmentioning

confidence: 99%

“…There is an extremely low incidence of malignancy associated with cardiac devices, with less than 25 reported in the literature. A case report and literature review by Zarifi and colleagues 7 reported a single case of large B-cell lymphoma arising from a CIED pocket along with a review of 15 previous reported cases of malignancy arising from CIED sites from 1976 to 2013. These reported cases were due to a wide variety of malignancies, including various types of breast cancer, adenocarcinoma, plasmacytoma, and sarcomas.…”

Section: Discussionmentioning

confidence: 99%