Metastatic Cardiac Tumors: Literature Review and Own Observation of Testicular Tumor Metastasis in the Right Ventricle of the Heart

Abstract

Background: Tumors of the heart are uncommon and usually benign (in 93% cases myxomas are observed). More often secondary, metastatic tumors are detected in the heart, as a rule, at pronounced progression of the malignant neoplasm with multiple lesions of other internal organs (lung, pleura, liver, etc.). Literature review on cardiac metastases of different tumors is given. Case Report: Own observation of a young man with rare single metastasis of malignant testicular germ cell tumor with predominance of embryonic carcinoma in the right ventricle of the heart is presented; the primary tumor was detected after metastasis revealing. The diagnostic algorithm using routine histological study supplemented with immunohistochemistry, including detection of cytokeratin pan, cytokeratin 5/6, cytokeratin 7, CD30, OCT4, TTF-1, hCG, and AFP markers expression, is described.

Cardiac Metastases in Patients with Neuroendocrine Tumours: Clinical Features, Therapy Outcomes, and Prognostic Implications

“…Even though management guidelines for the CM in NET have been published by ENETS [6], comprehensive description and experience are still lacking. Most literature studies regarding CM in NET over the past 10 years are small case series reports [7,8,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] (Table 5) that Compared to other cancer types, the incidence of CM in NET was relatively lower [9,[33][34][35]. Although no malignant tumours are known preferentially to involve the heart, some do involve the heart more often than others.…”

“…The tumours showing the highest rate of heart metastasis were as the following: pleural mesothelioma (48.4%), melanoma (27.8%), lung adenocarcinoma (21%), undifferentiated carcinomas (19.5%), lung squamous cell carcinoma (18.2%), and breast carcinoma (15.5%). High rates of heart metastasis have also been observed in patients affected by ovarian carcinoma (10.3%), lymphomyeloproliferative neoplasms (9.4%), bronchioalveolar carcinomas (9.8%), gastric carcinomas (8%), renal carcino-mas (7.3%), and pancreatic carcinomas (6.4%) [33][34][35]. However, the incidence of CM in NET was reported as 1-4% [9].…”

Cardiac Metastatic Tumors

“…It is worth noting that the patient had no other metastases. 13 Another study describes an interesting case of heart transplantation from a donor in whom the presence of a neoplasm in the retroperitoneal space (histopathologically mixed germ cell cancer-embryonal carcinoma with the component of yolk sac tumor) was discovered during organ retrieval, making the diagnosis of metastatic embryonal carcinoma of the testis. Despite the discovered malignant process in the donor, surgeons were forced to transplant the heart due to the initiation of a cardiectomy in the 57-year-old recipient.…”

“…6,9,10 Secondary malignant tumors in the heart tend to be located in the pericardium or myocardium, whereas intracavital location is rare. [11][12][13] According to Ziccardi et al, 5 in an autopsy series, the incidence of metastatic cardiac tumors among patients with cancer diagnosis was ∼20%. In theory, metastases can be caused by any malignant neoplasm, but the most common carcinomas that metastasize to the heart are listed in Table 1.…”

“…4 Cardiac tumors may not cause any manifestations and may be revealed by accident when performing radiologic diagnostics for other reasons, during surgery or autopsy, but among potential manifestations, 1 can find the states listed in Table 2. 1,5,6,9,13,15,17 The symptoms mostly regard the cardiovascular system, but there is a rare case reported on neuroendocrine heart-located tumor, in which the manifestation was diarrhea. 11 Less frequent manifestations may also include Raynaud phenomenon, thrombocytopenia, cyanosis, or clubbing.…”