Solitary Metastasis of Squamous Cell Carcinoma of the Bladder to the Myocardium

Stricker, P.D.; Grant, A. Kerr

doi:10.1016/s0022-5347(17)43893-6

Cited by 8 publications

(8 citation statements)

References 6 publications

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“…Cardiac metastases are much less common, with the first case reported in 1967 [7]. At the time of this publication we are aware of only three other reported instances of isolated cardiac metastasis from urothelial cell carcinoma [1-3]. …”

Section: Discussionmentioning

confidence: 99%

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Isolated cardiac metastasis from plasmacytoid urothelial carcinoma of the bladder

et al. 2012

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A 57-year-old male with a history of hypertension presented with shortness of breath, intermittent substernal chest pain, subjective fevers, and a 30-pound weight loss. He was found to have a bladder mass four months prior to presentation, for which he underwent cystoscopy and surgical removal. Pathology demonstrated high-grade superficial plasmacytoid urothelial carcinoma extending into the submucosa but not the muscularis propria. Given the superficial nature of his bladder cancer, a cystectomy was deferred. He was subsequently lost to follow-up care. On arrival, physical exam was notable for tachycardia, tachypnea, and distant heart sounds. An ECG showed an incomplete right bundle branch block and sinus tachycardia. Computed tomography pulmonary angiography revealed a three-cm pericardial effusion. Transthoracic echocardiography confirmed this finding and revealed a mass in the right ventricle (RV) extending into the outflow tract and infiltrating the free wall. The RV was dilated with an estimated RV systolic pressure of 37 mmHg. Pericardiocentesis yielded nearly one liter of serosanguinous fluid with non-diagnostic cytology. Partial median sternotomy with biopsy showed pathologic findings consistent with metastatic urothelial carcinoma, plasmacytoid variant. A PET scan showed increased uptake exclusively in the heart. The oncology team discussed options with the patient including chemotherapy and palliative care. The patient decided to withhold further therapy and went home with hospice care. He died two months later.DiscussionBladder cancer is the fourth most common cancer in men in the United States. Most patients (69%) with metastatic bladder cancer have multiple organs involved; conversely, our patient had a PET scan indicating his disease was localized to the heart. Plasmacytoid urothelial carcinoma is a rare subtype of bladder cancer, and is estimated to make up less than three percent of all invasive bladder carcinomas. At the time of this publication we are aware of only three other reported instances of isolated cardiac metastasis with urothelial bladder origin; none of which were the plasmacytoid variant.ConclusionThis case highlights a previously unreported presentation of plasmacytoid urothelial carcinoma. Clinicians must remember that even superficial cancers can have significant metastatic potential.

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Section: Discussionmentioning

confidence: 99%

“…A review of current literature yields only three other instances of this unusual metastatic pattern [1-3]. We present a 57-year-old male with plasmacytoid urothelial carcinoma (PUC) of the bladder and isolated metastasis to the heart.…”

Section: Introductionmentioning

confidence: 99%

Isolated cardiac metastasis from plasmacytoid urothelial carcinoma of the bladder

et al. 2012

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“…Of the ten cases of squamous cell cancer with cardiac metastases discussed above, only one originated from the bladder [2]; in fact, in the past twenty years, there were only two case reports of squamous cell carcinoma in the heart that originated from the bladder [2, 3]. Both of the cases had known diagnoses of bladder cancer prior to presentation; ours is the first case report of heart failure presenting as the initial symptom.…”

Section: Managementmentioning

confidence: 99%

“…Both of the cases had known diagnoses of bladder cancer prior to presentation; ours is the first case report of heart failure presenting as the initial symptom. Both patients died shortly after presentation; one died of pulmonary compromise from the cardiac mass [2] and the other died of a massive pulmonary embolus and was only discovered to have cardiac metastases at autopsy [3]. …”

Section: Managementmentioning

confidence: 99%

“…Here we discuss a case of a patient who presented with right heart failure and pulmonary emboli, whose ultimate diagnosis was metastatic squamous cell carcinoma of the bladder. In the past twenty years, there have been only two reports of squamous cell carcinoma in the heart that originated from the bladder [2, 3]; this is the first case of the cardiac mass being the presenting symptom.…”

Section: Introductionmentioning

confidence: 99%

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A Rare Case of Squamous Cell Carcinoma of the Bladder Presenting as a Metastatic Right Ventricular Mass

Bonsall

Hughes

Mosunjac

et al. 2010

Case Reports in Medicine

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A 74-year-old woman presented with bilateral lower extremity swelling, worsening dyspnea on exertion, and mild hemoptysis. An echocardiogram at time of admission showed a mass in the right ventricle. The pathology of a sample obtained via transvenous biopsy was consistent with squamous cell carcinoma; no primary source could initially be identified. Severe thrombocytopenia, likely consumptive, precluded surgical intervention, so the patient underwent palliative radiation. Unfortunately, she developed fatal respiratory failure. Upon autopsy, the bladder was found to contain polyps of invasive squamous cell carcinoma, similar in morphology to the tumor mass in the heart. Her lungs contained multiple tumor emboli at different stages, which was likely the final cause of her death. Squamous cell carcinoma metastases to the endocardium are extremely rare and without defined treatment. Surgery can improve prognosis in those with primary tumors that are benign or without metastases. In those with symptomatic metastatic tumors, palliative debulking can done although generally will not improve prognosis. It is currently unknown whether radiation improves survival. In this case, irradiation did destroy a portion of the tumor as the final pathology showed extensive necrosis of the tumor; unfortunately, it did not change her symptoms and did not change the final outcome.

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Solitary cardiac metastasis of urothelial carcinoma of the urinary bladder with squamous cell differentiation – a rare manifestation

Duwe

Fischer

Haack

et al. 2023

Urology Case Reports

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Solitary Metastasis of Squamous Cell Carcinoma of the Bladder to the Myocardium

Abstract: We report a case of an isolated cardiac metastasis from squamous cell carcinoma of the bladder. The incidence and difficulty in the diagnosis of myocardial deposits from bladder tumors are discussed.

Cited by 8 publications

References 6 publications

Isolated cardiac metastasis from plasmacytoid urothelial carcinoma of the bladder

Isolated cardiac metastasis from plasmacytoid urothelial carcinoma of the bladder

A Rare Case of Squamous Cell Carcinoma of the Bladder Presenting as a Metastatic Right Ventricular Mass

Solitary cardiac metastasis of urothelial carcinoma of the urinary bladder with squamous cell differentiation – a rare manifestation

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