Intracardiac metastasis from germ cell testicular tumor

Abstract

Intracardiac metastases of germ cell testicular tumors are not commonly seen in clinical practice. The clinical presentation of right-sided heart metastases ranges widely. Depending upon its size and intracardiac location, it could be highly symptomatic, leading to a congestive heart failure, pulmonary embolism, and death, or completely asymptomatic. Improved imaging techniques and treatment strategies demonstrate that right-sided heart metastasis should be considered a potentially dangerous but treatable disease. Presented is the case of a 24-year-old man with a testicular nonseminomatous germ cell tumor, which after metastasizing in the right atrium differentiated into a teratoma and resulted in an inflow obstruction of the right ventricle.

Unusual presentation of testicular rhabdomyosarcoma metastases to the right ventricle papillary muscle and tricuspid valve

“…An embryonal testicular RMS is rare and represents 7% of all testicular cancers. Testicular cancers usually metastasize to the paraaortic and mediastinal lymph nodes and cardiac involvement is very rare [2 , 3] . Right heart involvement is common than the left and this is attributed to spread of the tumor through inferior vena cava [9 , 10] .…”

“…Testicular tumors are the most common solid neoplasm in the male population under 45 years of age and they comprise 1%-2% of all malignant tumors in the male patients [1] . Intracardiac metastases from testicular tumors is a very rare entity with only very few case reports found in the literature [2 , 3] . However, none of those reports described involvement of papillary muscle.…”

Cardiac metastasis from yolk sac tumor: case report and review

“…In a review of the cases of germ cell tumors with cardiac metastasis published over the last 20 years (Table 1) [7-24] we found 17 cases: 16 of them were male with testicular seminoma or nonseminomatous germ cell tumor, and only one case of a yolk sac tumor was reported in a female child of 18 months old. In 11 of these reported cases, the metastasis was located in the right-side of the heart; in four, in a left-side chamber; and in two, in the pericardium.…”

“…Emergency surgical resection of intra-cardiac metastases has been recommended in the compromised patient and can be lifesaving [21]. New technical modalities (e.g., modern echocardiography, computed tomography, magnetic resonance imaging) provide noninvasive visualization of the intracardiac mass, which assists in designing the surgical approach not only to eliminate tumor tissue, but also to restore or maintain the hemodynamic status [14,24]. Most patients treated aggressively will be long-term survivors even if they have advanced disease.…”

A rare cause in etiology of left atrial mass: metastatic testicular germ cell tumor

“…Germ cell tumors account for almost 90% of all testis tumors. Although intracardiac metastases of testicular germ cell tumors occur rarely in clinics, they may lead to the congestive heart failure, paradoxical systemic emboli and vena cava superior syndrome with disseminated involvement of the right or left heart [ 2 – 5 ]. Metastatic tumors of the heart are seen more frequently when compared to primary tumors.…”