Case Report: Neuroendocrine Tumor With Cardiac Metastasis

Abstract

Neuroendocrine tumors (NETs), also known as carcinoid tumors, are a heterogeneous group of neoplasms that arise from cells throughout the neuroendocrine system, most commonly arising from the gastrointestinal (GI) tract, lungs, and bronchi. Myocardial carcinoid metastasis is rare with an incidence among metastatic carcinoid patients of 4%. They are generally asymptomatic and detected incidentally. Infiltrative myocardial metastasis secondary to carcinoid tumor is exceedingly rare with only single-digit cases reported in the literature. We report the case of a 65-years-old female with a newly diagnosed ileal neuroendocrine tumor as well as heart failure due to infiltrative myocardial metastasis.

Radioligand therapy (RLT) used to treat cardiac metastasis of pancreatic neuroendocrine tumor

“…Cardiac metastases from NEN are a relatively rare phenomenon per the literature, with an overall incidence of 4% 10 . Review of the literature showed only three case reports 10–12 and one case series 13 regarding treatment of patients with cardiac metastases secondary to neuroendocrine tumors.…”

“…It is rare to find myocardial metastasis from NEN, with an overall incidence of 4% among metastatic carcinoid patients 10 . Cardiac metastases are typically asymptomatic at presentation and detected incidentally.…”

“…It is rare to find myocardial metastasis from NEN, with an overall incidence of 4% among metastatic carcinoid patients. 10 Cardiac metastases are typically asymptomatic at presentation and detected incidentally. The rarity of cardiac NEN metastases makes it challenging to establish standardized treatment protocols.…”

Heart Failure in a Patient With Metastatic Well-Differentiated Neuroendocrine Tumor

“…Cardiac metastasis from primary neuroendocrine tumors is exceedingly rare and usually found incidentally on dotatate imaging (also called octreoscan). The incidence of intracardiac metastasis is approximately 4% in all patients with metastatic carcinoid tumors ( Kinney et al, 2020 ). Nonetheless, the advanced practitioner should rule out infiltrative cardiac metastasis by dotatate imaging as the cause of heart failure in this patient population.…”

Cardiac Metastasis of Neuroendocrine Tumor Without Cardiovascular Symptoms

“…Clinical presentation depends on the site and size of the metastasis. NET with cardiac metastasis is typically asymptomatic from a heart standpoint, but there is a recently reported case 4 where the patient presented with heart failure at the time of diagnosis. Metastasis to the left ventricle accounts for 53% of cases, compared with only 7% of metastasis to the intraventricular septum.…”