Metastatic cardiac tumors: from clinical presentation through diagnosis to treatment

Burazor, Ivana; Aviel‐Ronen, Sarit; Imazio, Massimo; Goitein, Orly; Perelman, Marina; Shelestovich, Natalia; Radovanović, N; Kanjuh, Vladimir; Barshack, Iris; Adler, Yehuda

doi:10.1186/s12885-018-4070-x

Cited by 62 publications

(63 citation statements)

References 23 publications

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“…Possible pathways for cardiac tumor spread are hematogenous pathway, lymphatic pathway, transvenous pathway, and direct invasion. [ 4 ] The pericardium is the most frequently involved site of cardiac metastasis, comprising 64% to 69% of all cardiac metastases. Epicardial involvement and myocardial involvement represent the second and third most common sites of cardiac metastasis.…”

Section: Discussionmentioning

confidence: 99%

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ST-segment elevation due to myocardial invasion of lung cancer mimicking ST elevation myocardial infarction

Jung¹

2021

Medicine

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Introduction: When a cancer patient presents with ST-segment elevation on an electrocardiogram (ECG), several causes including acute myocardial infarction (MI) should be considered. Myocardial metastasis is one of the rare causes of ST-segment elevation in cancer patients and its clinical silence makes it difficult to diagnose. Patient concerns: A 78-year-old man with lung cancer presented to the emergency room for chest pain. ECG revealed ST-segment elevation in inferior and lateral leads. Interventions: After emergent coronary angiography, percutaneous coronary intervention (PCI) on proximal right coronary artery was performed. Outcomes: Even 7 days after PCI, ST-segment elevation in inferior and lateral leads still existed. Cardiac markers continued to be within the normal range. Diagnosis: We found evidence of metastasis of lung cancer on the inferolateral wall of the myocardium by trans thoracic echocardiogram and positron emission tomography (PET)/computed tomography (CT). We diagnosed myocardial metastasis as the cause of ST-segment elevation in the patient. Conclusion: Myocardial metastasis is one of the differential diagnosis of ST-segment elevation in cancer patients. Periodic ECG is necessary for lung cancer patients and rapid cardiac work-up is recommended when ST-segment elevation is newly discovered.

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Section: Discussionmentioning

confidence: 99%

“…Therefore, early detection of cardiac metastases is challenging. [ 4 ]…”

Section: Discussionmentioning

confidence: 99%

ST-segment elevation due to myocardial invasion of lung cancer mimicking ST elevation myocardial infarction

Jung¹

2021

Medicine

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“…The most common cardiac metastases are carcinomas, tissue sarcomas, melanomas, and lymphomas [ 8 ]. Most secondary cardiac tumors are clinically silent (90%) and are often diagnosed postmortem [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic pitfalls: intramyocardial lymphoma metastasis mimics acute coronary syndrome in a diffuse large B cell lymphoma patient—case report

et al. 2021

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Background Cardiac tumors are very uncommon compared to other cardiac diseases. Their clinical symptoms can vary from absent to non-specific. The most common symptoms are arrhythmias, blood flow obstruction due to valvular dysfunction, shortness of breath, systemic embolization, and accumulation of pericardial fluid. Hereby, we describe a very rare case of a diffuse large B cell lymphoma patient who presented with the symptoms and signs of acute coronary syndrome (ACS) but the patient’s complaints were caused by his intramyocardial lymphoma metastasis. Case presentation Forty-eight-year-old diffuse large B cell lymphoma patient was admitted to our emergency department with chest pain, effort dyspnea, and fever. The patient had normal blood pressure, blood oxygen saturation, sinus tachycardia, fever, crackles over the left lower lobe, novum incomplete right bundle branch block with Q waves and minor ST alterations, elevated C-reactive protein, high-sensitivity troponin-T, and d-dimer levels. Chest X-ray revealed consolidation on the left side and enlarged heart. Bed side transthoracic echocardiography showed inferior akinesis with pericardial fluid. Coronary angiography showed no occlusion or significant stenosis. Chest computed tomography demonstrated the progression of his lymphoma in the myocardium. He was admitted to the Department of Hematology for immediate chemotherapy and he reached complete metabolic remission, followed by allogeneic hematopoietic stem cell transplantation. Unfortunately, about 9 months later, he developed bone marrow deficiency consequently severe sepsis, septic shock, and multiple organ failure what he did not survive. Conclusions Our case demonstrates a very rare manifestation of a heart metastasis. ACS is an unusual symptom of cardiac tumors. But our patient’s intramyocardial lymphoma in the right atrium and ventricle externally compressed the right coronary artery and damaged the heart tissue, causing the patient’s symptoms which imitated ACS. Fortunately, the quick diagnostics and immediate aggressive chemotherapy provided the patient’s remission and suitability to further treatment.

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“…The most common cardiac metastases are carcinomas, tissue sarcomas, melanomas and lymphomas [8]. Most secondary cardiac tumors are clinically silent (90%) and are often diagnosed postmortem [9].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Pitfalls: Intramyocardial Lymphoma Metastasis Mimics Acute Coronary Syndrome in A Diffuse Large B Cell Lymphoma Patient – Case Report

Prenek

Csupor

Besztercán

et al. 2020

Preprint

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Background: Cardiac tumors are very uncommon compared to other cardiac diseases. Their clinical symptoms can vary from absent to nonspecific. The most common symptoms are arrhythmias, blood flow obstruction due to valvular dysfunction, shortness of breath, systemic embolization, accumulation of pericardial fluid. Hereby, we describe a very rare case of a diffuse large B cell lymphoma patient who presented with the symptoms and signs of acute coronary syndrome (ACS) but the patient’s complaints were caused by his intramyocardial lymphoma metastasis.Case presentation: 48-year-old diffuse large B cell lymphoma patient was admitted to our emergency department with chest pain, effort dyspnea and fever. The patient had normal blood pressure, blood oxygen saturation, sinus tachycardia, fever, crackles over the left lower lobe, novum incomplete right bundle branch block with Q waves and minor ST alterations, elevated C-reactive protein, high-sensitivity troponin-T and d-dimer levels. Chest X-ray revealed consolidation on the left side and enlarged heart. Bed side transthoracic echocardiography showed inferior akinesis with pericardial fluid. Coronary angiography showed no occlusion or significant stenosis. Chest computed tomography demonstrated the progression of his lymphoma in the myocardium. He was admitted to the Department of Hematology for immediate chemotherapy and he reached complete metabolic remission, followed by allogeneic hematopoietic stem cell transplantation. Unfortunately, about 9 months later, he developed bone marrow deficiency consequently severe sepsis, septic shock and multiple organ failure what he did not survive.Conclusions: Our case demonstrates a very rare manifestation of a heart metastasis. ACS is an unusual symptom of cardiac tumors. But our patient’s intramyocardial lymphoma in the right atrium and ventricle externally compressed the right coronary artery, causing the patient’s symptoms which imitated ACS. Fortunately, the quick diagnostics and immediate aggressive chemotherapy provided the patient’s remission and suitability to further treatment.

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Metastatic cardiac tumors: from clinical presentation through diagnosis to treatment

Cited by 62 publications

References 23 publications

ST-segment elevation due to myocardial invasion of lung cancer mimicking ST elevation myocardial infarction

ST-segment elevation due to myocardial invasion of lung cancer mimicking ST elevation myocardial infarction

Diagnostic pitfalls: intramyocardial lymphoma metastasis mimics acute coronary syndrome in a diffuse large B cell lymphoma patient—case report

Diagnostic Pitfalls: Intramyocardial Lymphoma Metastasis Mimics Acute Coronary Syndrome in A Diffuse Large B Cell Lymphoma Patient – Case Report

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