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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This is a unique case of Merkel cell carcinoma, a rare neuroendocrine tumor, metastasizing to the heart and inducing a progression of cardiac complications such as new-onset atrial fibrillation, malignant pericardial effusion with tamponade physiology, first-degree heart block, and complete heart block. Metastases to the heart are relatively rare but should be suspected if a patient with a known neoplasm presents with new cardiac manifestations. This is the first case report of cardiac metastases from Merkel cell carcinoma causing cardiac tamponade or complete heart block. This case highlights the clinical decision-making involved in managing cardiac tamponade and complete heart block in the setting of metastatic disease to the heart.
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PMID:Complete heart block and cardiac tamponade secondary to Merkel cell carcinoma cardiac metastases. 1646 6

Malignant fibrous histiocytoma metastasizing to the left ventricle is an uncommon form of cardiac malignancy. This report describes a rare case of left ventricular metastases from a malignant fibrous histiocytoma of the posterior compartment of the right thigh, recurring five years after treatment with surgery, hyperthermic perfusion of the limb and radiotherapy. As the patient presented symptoms of cardiac tamponade, open heart surgery was performed through a median sternotomy; however, the tumor was not resectable and only a biopsy was performed. A partial response was obtained with standard and high-dose chemotherapy with peripheral blood progenitor cell transplantation. The response continued to improve with immunotherapy. The patient returned to normal physical activity. He died four years later due to a ventricular arrhythmia.
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PMID:Cardiac metastases in malignant fibrous histiocytoma. A case report. 1668 88

Breast cancer rarely metastasizes to the pericardial cavity to cause cardiac tamponade. We have recently experienced a case of pericardial tamponade due to recurrent breast cancer. A 41-year-old woman who underwent modified radical mastectomy for a right breast cancer (T(1)N(3)M(0), Stage IIIA) 8 years and 8 months ago, was admitted for dyspnea and cough. Chest X-ray and CT scan revealed cardiomegaly and right pleural effusion, and cardiac echogram showed marked retention of pericardial effusion. A diagnosis of cardiac tamponade was made, and pericardiocentesis and thoracentesis were carried out immediately. Based on cytodiagnosis of pericardial and pleural effusion, the diagnosis was pericardial and intrapleural metastases of the breast cancer. Dyspnea was improved by pericardiocentesis and thocacentesis. Both intrapericardiac and intrathoracic instillation of CDDP prevented reaccumulation of pericardial and pleural effusion. After local chemotherapy with CDDP, systemic chemotherapy of CPT-11 was started. Thereafter the patient was discharged from the hospital and recovered her daily activities. This case indicates that intrapericardiac application of CDDP was effective for carcinomatous cardiac tamponade without serious side effects.
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PMID:[A case of pericardial tamponade caused by recurrent breast cancer treated with intrapericardial and intrapleural infusion of cisplatin (CDDP)]. 1691 34

Uveal melanoma differs from cutaneous melanoma in many ways, including its pattern of metastasis, and exhibits latency with clinical evidence of metastasis sometimes appearing many years after primary diagnosis. Most patients develop metastasis within the liver, but some may present with metastasis to other sites. We report a case of uveal melanoma that presented with post-menopausal bleeding due to metastasis. Further investigation revealed widespread metastatic disease and the patient was not fit for chemotherapy. She died two months after presentation: autopsy revealed metastases in many sites, including the uterus, right ovarian fibroma, kidney, mesentery, liver, lung, thyroid, bone marrow and skin. The immediate cause of death was cardiac tamponade due to a malignant effusion secondary to cardiac metastasis. This case illustrates the widespread metastatic potential of uveal melanoma and highlights the potential for unusual presentation of metastatic disease from this eye tumor.
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PMID:Post-menopausal bleeding: a rare presentation of metastatic uveal melanoma. 1699

We present a case of a 49-year-old patient with cardiac tamponade due to haemopericardium. The decision to perform surgery, although controversial, allowed to diagnose cardiac angiosarcoma with metastases to pericardium, vena cava superior and pulmonary trunk. Consequently, chemotherapy was instituted and was initially effective, however, the patient died 12 months later due to the progression of the disease.
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PMID:[Cardiac tamponade due to angiosarcoma--was surgical treatment necessary? A case report]. 1720 43

Metastatic cardiac malignancies mainly come from the lung, breast, and the lymphoreticular system by direct invasion or hematogenous or lymphatic spread. Metastasis from colorectal cancer to the heart or pericardium is seldom reported and only sporadic antemortem cases have been reported. We report an unusual case of malignant pericardial effusion caused by metastatic adenocarcinoma of colon. Malignant pericardial effusion and subsequent tamponade was the earliest manifestation without any other confirmed clinical metastases. Pericardiotomy was performed to relieve the life-threatening cardiac tamponade. We report this rare case and review the literature.
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PMID:Cardiac tamponade as the initial manifestation of metastatic adenocarcinoma from the colon: a case report. 1765 Apr 60

Primary pericardial sarcomas are very rare. A 62-year-old Japanese man presented with cardiac tamponade. Echocardiography, computed tomography and magnetic resonance imaging revealed massive pericardial effusion and a large tumor in the pericardial cavity, attached to the pericardium of the left ventricular posterolateral free wall. Surgical excision of the tumor was performed and histopathological and immunohistochemical examinations identified high-grade myofibroblastic sarcoma. Because of local recurrence soon after surgery, the patient received adjuvant chemotherapy, including doxorubicin and ifosfamide, and subsequent radiotherapy. As of 6 months after completing radiotherapy, the patient was alive and no disease progression or distant metastases were evident. This may be the first report of primary high-grade myofibroblastic sarcoma arising from the pericardium.
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PMID:Primary high-grade myofibroblastic sarcoma arising from the pericardium. 1821 77

Trastuzumab (Herceptin) is well documented in reducing suffering and mortality from breast cancer. The clinically most important side effect of Herceptin is cardiotoxicity, which is reported in 2.6% to 4.5% of patients receiving trastuzumab alone and in as many as 27% of patients when trastuzumab is combined with an anthracycline in metastatic disease. We reported the case of a 50-year-old woman who presented to our emergency department (ED) because of chest pain and shortness of breath. On physical examination, holosystolic murmur over apex could be heard. Pulmonary and abdominal examinations were unremarkable. Twelve-lead electrocardiography showed sinus tachycardia and new onset of complete left bundle-branch block. Emergent transthoracic echocardiography revealed generalized hypokinesia of left ventricle and akinesia over interventricular septum and apex. She subsequently underwent immediate coronary angiography that revealed normal coronary angiography, and left ventriculogram revealed generalized hypokinesia with severe left ventricle dysfunction with ejection fraction of 33%. During right heart catheterization and endomyocardial biopsy, cardiac tamponade developed and was successfully relieved by pericardial window. She was discharged event-free 3 weeks later with conservative treatment. Although new onset of complete left bundle-branch block in a patient with chest pain may be acute coronary syndrome, careful review of medicine history is mandatory to avoid unnecessary procedure and complications.
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PMID:Trastuzumab (Herceptin)-associated cardiomyopathy presented as new onset of complete left bundle-branch block mimicking acute coronary syndrome: a case report and literature review. 1968 38

Primary cardiac angiosarcoma is a rare and aggressive tumor. Diagnosis is usually late because of the rarity of the lesion and the nonspecific clinical symptoms. We report the case of a 48-year-old man affected by angiosarcoma of the right atrium who presented with subacute cardiac tamponade. Extensive resection of the atrial wall infiltrated by the tumor, followed by autologous pericardial free atrial wall reconstruction, was successfully carried out. In spite of the optimal early outcome, the patient died 15 months later because of multiple osteal metastases.
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PMID:A case of primary cardiac angiosarcoma: extensive right atrial wall reconstruction with autologous pericardium. 1984 Jan 86

We report a case of a 48-year-old man with a history of violent coughing fits and general fatigue underwent urgent surgery for cardiac tamponade, and who was later diagnosed with metastatic intracardiac squamous cell carcinoma of the esophagus. After admittance to Munakata Suikokai General Hospital, Fukuoka, Japan, echocardiography showed extensive pleural and pericardial effusion and a mass, 4 by 2 cm, with a solid echo pattern in the right ventricular cavity. The working diagnosis was primary malignant cardiac tumor of unknown origin with multiple metastases. To prevent sudden death due to obliteration of the outflow tract of the right ventricle, we performed urgent surgery for cardiac tamponade. Histological examination of the resected tumor revealed squamous cell carcinoma. Fiberoptic esophagoscopy showed hypertrophy of the esophageal wall and a submucosal tumor extending throughout the esophagus. Microscopic examination of the esophagus biopsy specimen showed moderately differentiated squamous cell carcinoma, the histology of which was similar to that of the resected tumor and cytology of pericardial effusion. The patient recovered and was able to return home for a few days; however, he was readmitted, and despite maximal supportive therapy, he died one month after the operation.
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PMID:Intracardiac metastasis of esophageal squamous cell carcinoma -report of a case-. 2159 14


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