Successful management of intracardiac extension of tumor thrombus in a patient with advanced nonseminomatous germ cell testicular cancer

Savarese, Diane; Rohrer, Michael J.; Pezzella, A. Thomas; Davidoff, Ashley; Fraire, Armando E.; Menon, Mani

doi:10.1016/s0090-4295(99)80366-5

Cited by 29 publications

(18 citation statements)

References 20 publications

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“…Although less common, direct tumor spread from the liver, adrenal glands, pelvic organs, retroperitoneal masses and lymph nodes can also involve the IVC [56][57][58]. Detection of IVC involvement has been greatly improved over the past two decades by the routine use of CT and ultrasound as well as more recently MRI in the evaluation of the abdomen and pelvis.…”

Section: Vascular Invasion and Resectabilitymentioning

confidence: 99%

CT for intracardiac thrombi and tumors

Tatlı

Lipton

2005

Int J Cardiovasc Imaging

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Although cardiac tumors are rare, they nevertheless represent an important subgroup, the diagnosis of which is challenging for the primary care physician. Symptoms are not characteristic and serious complications including stroke, myocardial infarction and even sudden death from arrhythmia may be the first signs of tumor. The most common primary cardiac neoplasm is the benign myxoma and the most frequent primary malignant lesion is sarcoma. Cardiac metastases from distant primary carcinomas are now frequently encountered. Echocardiography until the past decade was the only consistently reliable and available non-invasive diagnostic tool. New non-invasive CT and MRI exams are changing the diagnostic approach. Echocardiography and angiocardiography with or without coronary arteriography remain routine methods for evaluating cardiac neoplasms. However, CT provides additional diagnostic information and is regarded as essential for adequate staging and treatment planning, particularly when surgical resection is being considered. This chapter reviews the wide spectrum of intracardiac thrombi and tumors including their incidence and imaging characteristics with particular reference to the CT findings and differential diagnosis.

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Section: Vascular Invasion and Resectabilitymentioning

confidence: 99%

CT for intracardiac thrombi and tumors

Tatlı

Lipton

2005

Int J Cardiovasc Imaging

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“…Computed axial tomography was used preoperatively for demonstrating tumour extension. A similar case of a young patient with non-seminomatous germ cell testicular cancer was described by Savarese et al [11]: Due to an IVC tumour thrombus extending into the right heart, tumour thrombectomy was performed utilizing cardiopulmonary bypass and hypothermic circulatory arrest. Afterwards, the patient underwent systemic chemotherapy.…”

Section: Discussionmentioning

confidence: 68%

Intraluminal Tumour Thrombus of a Mixed Non-Seminomatous Germ Cell Tumour of Testis within the Inferior Vena Cava

Badawi

Kittner²,

Manseck³

et al. 2005

Oncol Res Treat

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Intracaval tumour thrombus developed per continuitatem from a primary testicular tumour is rare. Case Report: A patient with metastatic mixed non-seminomatous germ cell tumour of the testis extending into the inferior vena cava (IVC) is presented. He belonged to the intermediate-risk group according to the IGCCCG (International Germ Cell Cancer Collaborative Group) classification. The 26-year-old man underwent right inguinal orchiectomy. Computed tomography revealed the tumour thrombus as filling defect in the IVC extending nearly to the right renal vein. Duplex sonography detected a partial thrombosis of the IVC. Combination chemotherapy led to regression of pulmonal metastases and the intraluminal tumour thrombus. 5 months later, retroperitoneal lymphadenectomy was performed and the intraluminal thrombus was extracted by cavotomy. The thrombus originated from the ostium of the right testicularis vein in the IVC. Histological examination revealed no vital tumour tissue. Conclusion: In patients with testicular cancer information about pathological processes of the IVC is important for therapeutic management. Testicular tumours seldom extend up the IVC.

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“…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.…”

Section: Discussionmentioning

confidence: 99%

Cardiac metastasis from yolk sac tumor: case report and review

2013

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Cardiac metastasis of germ cell tumors is extremely rare, particularly in females. We report a case of a 26-year-old previously healthy woman who presented with a 5-month history of abdominal pain, weight loss, fever, generalized lymphadenopathy, and acanthosis nigricans. Biopsy of cervical lymph nodes revealed a poorly differentiated neoplasm. Immunohistochemical staining was positive for alpha-fetoprotein suggesting the diagnosis of a germ cell tumor. During the investigation, the patient developed heart failure and a mass attached to the right ventricle was detected by the echocardiogram. In a few days, she developed multiple organ failure and died. Post-mortem examination revealed a malignant mixed germ cell tumor of the right ovary with extensive hematogenic and lymphatic dissemination, a polypoid mass attached to the right ventricle, emboli in the endocardial and epicardial vessels, and infiltration surrounding the coronary arteries. To the best of our knowledge this is the third report of grossly visible heart metastases from a yolk sac tumor in a female patient. A summary of all published cases of germ cell tumors with cardiac metastasis over the last 20 years is also presented.

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Successful management of intracardiac extension of tumor thrombus in a patient with advanced nonseminomatous germ cell testicular cancer

Cited by 29 publications

References 20 publications

CT for intracardiac thrombi and tumors

CT for intracardiac thrombi and tumors

Intraluminal Tumour Thrombus of a Mixed Non-Seminomatous Germ Cell Tumour of Testis within the Inferior Vena Cava

Cardiac metastasis from yolk sac tumor: case report and review

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