Right ventricular metastasis of cervical squamous cell carcinoma

Itoh, Ken‐ichi; Matsubara, Tatsuaki; Yanagisawa, Kiyoshi; Hibi, Norio; Nishimura, Kinya; Kambe, Tadashi; Sakamoto, Nobuo; Tanaka, Minoru; Abe, Toshio

doi:10.1016/0002-8703(84)90771-3

Cited by 22 publications

(8 citation statements)

References 6 publications

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“…Cardiac involvement is rare; the right ventricle is the most frequently involved, followed by the endocardium. The septum and left ventricle may occasionally be involved [8][9][10] . Autopsy studies show an incidence of cardiac metastasis of uterine cervix tumors between 3 and 4% 1 .…”

Section: Squamous Cells Cellular Atypiamentioning

confidence: 99%

Tumor metastático espinocelular de cérvix uterino para coração: diagnóstico ante mortem

Ferraz

Martins

Souza

et al. 2006

Arq. Bras. Cardiol.

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Sixty-three-year-old woman with a past medical history of uterine cancer and complaint of fatigue and dyspnea on mild exertion. Physical examination revealed hypertension and rales at lung bases. A transthoracic echocardiogram showed a mass with reduced mobility in the right ventricle. The patient was taken to surgery during which a mass involving the anterior wall of the pulmonary artery, tricuspid valve, right atrium, and posterior wall of the right ventricle was found. The pulmonary artery and the right ventricle were reconstructed with a bovine pericardium patch and the tricuspid valve was replaced by a number-31 biological prosthesis. The pathological examination revealed metastasis of squamous cells with well-differentiated infiltrative areas. The patient was discharged one month after surgery. Four months later, however, she was readmitted to hospital in terminal stage, confirming the guarded prognosis of the disease at this stage. Cardiac metastases from squamous cell carcinoma of the uterine cervix are uncommon findings; however their diagnosis and successful surgical treatment are even rarer.Among the several different types of neoplasia that may affect the heart, secondary tumors are 40 times more common than primary tumors 1 and the most varied types of tumors may attack the heart The main tumors to metastasize to the heart are, in descending order, melanoma, leukemias, bronchogenic tumors, and breast cancer. Metastasis from squamous cell carcinoma of the uterine cervix is one of the less frequent metastases, occurring in 5.9% of the cases 2 .The metastatic squamous cell carcinoma of the uterine cervix is one of the less common secondary tumors and it is difficult to be diagnosed; most of them are only found in autopsies. When symptomatic, it may cause arrhythmias, and may lead to complete heart block, pericardial tamponade, congestion due to myocardial replacement by tumor cells, intracardiac obstructions, myocardial infarction, peripheral embolism, and others. True myocardial infiltration or a simple intracardiac extension of the vena cava or of the pulmonary vein may occur 3 .In the present case, we report the in vivo diagnosis and the importance of considering cardiac metastasis in carcinoma of the uterine cervix, since this is a common disease among women and the symptoms of metastases are unspecific. Case ReportFemale, 63 years of age, born in the State of Santa Catarina, Brazil, was referred to the Department of Cardiovascular Surgery of a University Hospital in the city of Curitiba with a previous diagnosis of cardiac tumor and past medical history of uterine cervix cancer diagnosed at the age of 30 after three miscarriages, and treated with surgical resection (conization), 35 sessions of radiation therapy, and 3 sessions of chemotherapy.Two months prior to the hospitalization for evaluation of the cardiac tumor mass, the patient underwent angioplasty, and the obstruction of the anterior descending coronary artery was reduced by 80%. At admission she complained of fatigue and dyspnea on mild ...

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Section: Squamous Cells Cellular Atypiamentioning

confidence: 99%

Tumor metastático espinocelular de cérvix uterino para coração: diagnóstico ante mortem

Ferraz

Martins

Souza

et al. 2006

Arq. Bras. Cardiol.

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“…Myocardial or endocardial involvement of cervical carcinoma is rare, with only 2 cases involving the interventricular septum, 9,10 1 case of the left atrium, 11 1 in the LV, 12 and 13 cases of RV involvement, 5,9,11-18 6 of which were an isolated cardiac metastasis without evidence of other metastases. The most likely route of spread for these cervical carcinomas is hematogenously through the cervical venous plexus, into the inferior vena cava and right atrium and ultimately to the RV, where the carcinoma cells attach to the cardiac endothelial surface and begin to proliferate.…”

Section: Discussionmentioning

confidence: 99%

Right Ventricular Metastasis From a Primary Cervical Carcinoma

et al. 2001

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he incidence of cardiac metastases at autopsy ranges from 1.5% to 20.6% (mean 6%) in patients with malignant diseases. [1][2][3] Carcinomas of the lung and breast, malignant melanoma, lymphomas, and leukemias rank among the most common tumors associated with this condition. 4,5 Modes of spread to the heart include direct invasion, hematogenous spread, and lymphogenous metastasis. The most common site of cardiac involvement is the pericardium with frequencies ranging from 62% to 81%, 6 whereas myocardial or endocardial involvement is rare.For cervical carcinoma, the most common sites of extrapelvic metastasis are the lung, bone, or the cervical or supraclavicular lymph nodes. 7 Cardiac metastasis is very rare with a frequency ranging from 1.6% to 8.0%. 8 We report a case of right ventricular (RV) metastasis from a primary cervical carcinoma. Case ReportA 49-year-old female presented with a 1-month history of cough and low-grade fever. Vital signs at the time of presentation were height of 151 cm, weight of 44 kg, temperature of 37.4°C, heart rate of 120 beats/min, and blood pressure 120/82 mmHg. Jugular venous distension was not evident, nor were superficial lymph nodes palpable. A systolic ejection murmur was noted at the second intercostal space near the left sternal border. An abnormal mass, which was the size of a hen's egg, was palpable in the right lower quadrant just below the umbilicus. No edema was noted. Chest X-ray demonstrated mild cardiac enlargement without pleural effusion or abnormal lung shadows. Electrocardiography (ECG) revealed sinus tachycardia, inverted T waves in leads V1 to V4, and low voltage in the limb leads. A 49-year-old female presented with a 1-month history of cough and low-grade fever. Echocardiography showed a large mass in the right ventricle and percutaneous right ventricular endomyocardial biopsy provided the histologic diagnosis. Despite radiotherapy and chemotherapy, the patient died. At autopsy, the metastatic deposit in the heart was larger than the primary cervical carcinoma. (Jpn Circ J 2001; 65: 761 -763)

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“…Secondary heart tumors usually remain silent and are discovered only at autopsy . Echocardiography should be performed as soon as symptoms of heart failure, angina pectoris, embolism, or rhythm disturbances develop or heart size increases radiologically . In this case, the mechanism of spread was most likely hematogenous through the coronaries and residing in the coronary sinus.…”

Section: Commentmentioning

confidence: 99%

“…Cervical carcinoma commonly metastasizes to the liver, bone brain, and lung . Cardiac metastasis from uterine cancer is very rare with a frequency ranging from 1.6% to 8.0% . Secondary heart tumors usually remain silent and are discovered only at autopsy .…”

Section: Commentmentioning

confidence: 99%

“…Cardiac metastasis from uterine cancer is very rare with a frequency ranging from 1.6% to 8.0% . Secondary heart tumors usually remain silent and are discovered only at autopsy . Echocardiography should be performed as soon as symptoms of heart failure, angina pectoris, embolism, or rhythm disturbances develop or heart size increases radiologically .…”

Section: Commentmentioning

confidence: 99%

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