Unusual metastatic localization of osteosarcoma in a teenager with ventricular tachycardia

Tekbaş, Ebru; Tekbaş, Güven; İslamoğlu, Yahya; Atılgan, Zuhal Arıtürk; Çil, Habib; Ekıcı, Faysal; Gümüş, Hatice; Önder, Hakan

doi:10.1016/j.ajem.2010.01.021

Cited by 4 publications

(3 citation statements)

References 11 publications

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“…The incidence of cardiac metastasis ranges from 2% to 18% 12, most commonly from lymphoma, leukemia, melanoma, and lung, breast, and esophageal carcinoma 13. Cardiac metastases of sarcoma are exceedingly rare, with case reports in osteosarcoma and Ewing's Sarcoma 14, 15. The majority of patients with cardiac metastasis are asymptomatic from the lesion but symptoms can include shortness of breath or tamponade from pericardial involvement or arrhythmia from infiltration of the conduction system 12.…”

Section: Discussionmentioning

confidence: 99%

Cardiac metastasis and hypertrophic osteoarthropathy in recurrent infantile fibrosarcoma

Shah

Price

Loeb

2011

Pediatric Blood & Cancer

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Cardiac metastasis and hypertrophic osteoarthropathy are both quite rare. We describe a patient presenting with hypertrophic osteoarthropathy as the first symptom of recurrent infantile fibrosarcoma (IF). During surgical resection of lung metastasis, the patient suffered sudden cardiac arrest. Autopsy demonstrated a metastatic lesion in the intraventricular septum of the heart, which is previously undescribed in the literature. This case demonstrates that IF can be aggressive despite its more typical benign course.

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Section: Discussionmentioning

confidence: 99%

Cardiac metastasis and hypertrophic osteoarthropathy in recurrent infantile fibrosarcoma

Shah

Price

Loeb

2011

Pediatric Blood & Cancer

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“…Amiodarone suppressed recurrent VT in our patient, as well as in others. 10,25,29,32 However, aggressive antiarrhythmic therapy, although often necessary, is not always successful: amiodarone and tocainide failed to prevent sudden cardiac death in a patient who had osteosarcoma. 24 Resection.…”

Section: Management Of Tumor-induced Ventricular Tachycardiamentioning

confidence: 99%

“…We found only one report of a tumor smaller than 1.8 cm in its greatest dimension 27 -and, in most cases, the tumor was substan-tially larger (Table I). 9,25,26,[28][29][30][31][32][33][34][35][36][37] Metastatic melanomas, lymphomas, rhabdomyosarcomas, leiomyosarcomas, osteosarcomas, and oral, renal, and lung cancers have been associated with VT.…”

Section: Tumor-induced Ventricular Tachycardiamentioning

confidence: 99%

Ventricular Tachycardia Associated with Radiation-Induced Cardiac Sarcoma

Beaty¹,

Ballany²,

Trohman³

et al. 2014

Texas Heart Institute Journal

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M etastatic cardiac tumors can be diagnosed after various presentations, such as ventricular arrhythmia. We describe the case of a woman who had breast cancer with resultant radiation-induced sarcoma. Myocardial invasion was confirmed after she presented with ventricular tachycardia (VT). In addition, we review tumor-associated VT and the relevant medical literature. Case ReportIn July 2012, a 52-year-old woman presented with palpitations. In 2001, she had been diagnosed with left-breast cancer and had undergone lumpectomy, radiation, and chemotherapy with adriamycin, cytoxan, and taxol. Because of a reported history of cardiomyopathy, she had not been given herceptin. In December 2010, she was diagnosed with radiation-induced left-breast sarcoma with extension to the pectoralis muscles and lungs. A preoperative echocardiogram revealed a left ventricular ejection fraction (LVEF) of 0.45. The patient underwent tumor resection and neoadjuvant chemotherapy with 3 cycles of etoposide and ifosfamide, then declined further chemotherapy. Her LVEF decreased to 0.30 in September 2011, and angiotensin-converting enzyme inhibitor and β-blocker therapy was initiated. In November 2011, computed tomograms revealed an interval increase in lung nodules. The patient underwent resection and 2 cycles of chemotherapy with gemcitabine and taxotere, then declined additional chemotherapy. In March 2012, an echocardiogram revealed an LVEF of 0.20 to 0.25. Because of her poor prognosis after refusing chemotherapy, she was not offered a defibrillator.At the July 2012 presentation, the results of physical examination were unrevealing. The results of laboratory tests, including electrolytes and cardiac enzymes, were within normal limits. An electrocardiogram (ECG) on presentation revealed sinus rhythm with right bundle branch block (RBBB) and ST-segment elevation in leads V 1 through V 3 (Fig. 1A)-new since an ECG a year earlier (Fig. 1B). An echocardiogram revealed a new large, fixed echogenic mass on the right ventricular (RV) free wall with protrusion into the RV cavity (Fig. 2). In the cardiac care unit, the patient developed sustained wide-complex tachycardia that was consistent with VT (Fig. 3). The VT had

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Cardiovascular involvement by osteosarcoma: an analysis of 20 patients

et al. 2015

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Background Although hematogenous spread of osteosarcoma is well known, the imaging findings of cardiovascular involvement by osteosarcoma are seldom reported and can be difficult to recognize. The enhanced resolution of modern CT and MRI scanners may lead to better detection of cardiovascular involvement. Objective To describe the key imaging findings and clinical behavior of cardiovascular involvement by osteosarcoma. Materials and methods We retrospectively reviewed the imaging findings and clinical characteristics of 20 patients with cardiovascular involvement by osteosarcoma identified by two pediatric radiologists from a review of imaging studies at our institution from 2007 to 2013. Results At initial diagnosis, the median age of the patients was 15.1 years (range 4.8–24.6 years), and 7 (35%) patients had detectable metastases. Median time to detection of cardiovascular metastases was 1.8 years (range 0–7.3 years). Sixteen patients died of disease; 4 have survived a median of 7.4 years since initial diagnosis. The sites of cardiovascular involvement were the systemic veins draining the primary and metastatic osteosarcoma, pulmonary arteries, pulmonary veins draining the pulmonary metastases, and heart. A dilated and mineralized terminal pulmonary arteriole is an early sign of metastatic osteosarcoma in the lung. Unfamiliarity with the imaging features resulted in under-recognition and misinterpretation of intravascular tumor thrombus as bland thrombus. Conclusion Knowledge of imaging findings in the era of modern imaging modalities has enhanced our ability to detect cardiovascular involvement and lung metastases early and avoid misinterpreting tumor thrombus in draining systemic veins or pulmonary arteries as bland thrombus.

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Unusual metastatic localization of osteosarcoma in a teenager with ventricular tachycardia

Cited by 4 publications

References 11 publications

Cardiac metastasis and hypertrophic osteoarthropathy in recurrent infantile fibrosarcoma

Cardiac metastasis and hypertrophic osteoarthropathy in recurrent infantile fibrosarcoma

Ventricular Tachycardia Associated with Radiation-Induced Cardiac Sarcoma

Cardiovascular involvement by osteosarcoma: an analysis of 20 patients

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