Uncommon Cardiac Metastasis in Common Carcinoma Colon

Abstract

Colon carcinoma (CA) is one of the most common cancers worldwide. Cardiac metastasis in CA is quite rare with only a few incidences. These tumors are usually clinically silent and are discovered on autopsy. We present a case of a 62-year-old woman, known diabetic, hypertensive, and hypothyroid patient, who presented with complaints of abdominal distention and obstipation with multiple episodes of vomiting undigested food particles for three days. She had been passing dark tarry stools infrequently for over a month. She complained of a progressive loss of appetite and 5 kg weight loss over a month. Her examination revealed pallor and irregular pulse with a rate of 94/min. She had a distended non-tender abdomen and absent bowel sounds. Contrast-enhanced computed tomography (CECT) abdomen showed circumferential thickening of the descending colon, causing acute stenosis with multiple liver metastases and enlarged pericolic lymph nodes. Serum carcinoembryonic antigen (CEA) was elevated, 55.45 ng/mL. She underwent an emergency exploratory laparotomy with transverse loop colostomy. Histopathology report showed moderately differentiated adenocarcinoma. ECG showed atrial fibrillation and two-dimensional echocardiogram showed right ventricular metastasis. High-resolution computed tomography (HRCT) thorax was done to confirm the diagnosis.The common sites of metastases from colorectal cancer are the lymph nodes, liver, and lungs. When cardiac metastasis occurs, it often presents with features of heart failure. Our patient presented with atrial fibrillation. As the incidence of cardiac metastasis is quite rare, there is no standard established treatment. Certain chemotherapeutic drugs, such as 5-fluorouracil, oxaliplatin, irinotecan (FOLFIRINOX regimen), have been shown to improve cardiac metastases. Due to the extensive spread of primary cancer in our patient, she was planned for palliative chemotherapy; however, the patient expired before initiation of therapy.

Cardiac Metastatic Tumors

“…The patient was scheduled for 6 cycles of palliative chemotherapy, but the patient died before treatment began. 31 The heart is rarely described as a site of metastasis of colorectal cancer, and the incidence of this situation may be underestimated due to the lack of characteristic clinical signs. It may be reasonable to target the myocardium when performing routine checks during the diagnosis of colorectal cancer.…”

“…It may be reasonable to target the myocardium when performing routine checks during the diagnosis of colorectal cancer. 31…”

“…Examination of peritoneal fluid collected during laparoscopy showed the presence of moderately differentiated adenocarcinoma cells. The patient was scheduled for 6 cycles of palliative chemotherapy, but the patient died before treatment began 31…”

Cardiac metastasis from small cell lung cancer origin: A case report and review of the literature

“…Whereas any type of cancer may spread to the heart, the most frequent origins of MCTs are malignant melanoma and leukemia 4 . Cardiac metastases arising from breast, head and neck and colon cancer have been reviewed elsewhere 5–7 . However, cardiac metastasis from SCLC is often symptomless and rarely diagnosed until cancer cells appear in the pericardial effusion.…”

“… 4 Cardiac metastases arising from breast, head and neck and colon cancer have been reviewed elsewhere. 5 , 6 , 7 However, cardiac metastasis from SCLC is often symptomless and rarely diagnosed until cancer cells appear in the pericardial effusion.…”