Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 62-year-old man presented with 2 weeks of progressive dyspnea and chest pain. He was previously diagnosed with high-grade invasive urothelial carcinoma (UC) of the bladder and underwent neoadjuvant chemotherapy followed by radical cystectomy 10 months earlier, resulting in pathologic complete remission. Clinical evaluation and echocardiographic imaging was consistent with a diagnosis of cardiac tamponade. Due to a history of malignancy, the patient was referred for a surgical pericardial window, to include biopsy of the pericardium. Pericardial fluid and pericardial biopsy specimens were consistent with metastatic UC. Cardiac tamponade due to metastatic UC is a rare presentation, and, to our knowledge, there have been only 5 cases reported in the English literature. We report a rare case of cardiac tamponade due to isolated pericardial metastases from high grade UC of the bladder and discuss the symptoms, treatment, and prognosis of this pathologic condition. We also present a brief review of previously published literature. Through this discussion, we would like to emphasize the (1) consideration of cardiac metastases in the differential diagnosis for patients with a history of UC presenting with cardiac or pulmonary symptoms and (2) improved diagnostics with pericardial biopsy and pericardiocentesis over pericardiocentesis alone.
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PMID:A Rare Presentation of Cardiac Tamponade from Metastatic Urothelial Carcinoma of the Bladder. 3161 82

Salivary duct carcinoma (SDC) is a relatively rare highly aggressive salivary gland tumor. Although SDC shows frequent lymph node and distant metastases, the presence of neoplastic cells in the pleural effusion is extremely rare. In this report, we describe the first documented cytological case of metastatic SDC in cardiac and pleural effusions with immunocytochemical analyses for androgen receptor (AR) and human epidermal growth factor receptor (HER)2. A 52-year-old Japanese male developed cardiac tamponade and respiratory discomfort after surgery and chemo-radiation therapy for SDC of the right submandibular gland. Aspiration of the cardiac and pleural effusions was performed. The Papanicolaou-stained cytological specimens of cardiac and pleural effusions showed that numerous small ball-like or papillary structures were present in an inflammatory background. The neoplastic cells had rich granular cytoplasm and large round to oval nuclei containing conspicuous nucleoli. Immunocytochemical analyses clearly demonstrated positivity for AR and strong membranous expression of HER2 in the neoplastic cells. Accordingly, a cytodiagnosis of metastatic SDC was made. Recently, HER2-targeted or AR deprivation therapy have been introduced for patients with SDC, therefore, determination of expression profiles of AR and HER2 may be crucial for developing a treatment strategy for patients with metastatic SDC. According to the results of the present report, immunocytochemical analyses for AR and HER2 in the effusion specimens may be useful for determination of a treatment strategy for patients with metastatic SDC.
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PMID:Metastatic salivary duct carcinoma in cardiac and pleural effusions: A case report with immunocytochemical analysis for androgen receptor and HER2. 3065 80

Cutaneous malignant melanoma is one of the few malignancies that can metastasize to the heart. It is important not to miss cardiac metastases on imaging as they are often clinically asymptomatic, but if present and undiagnosed could lead to significant cardiac compromise, arrhythmias, congestive heart failure, cardiac tamponade or transient ischaemic attacks. Identifying intracardiac metastases on imaging often requires a multimodality approach as they can evade detection due to cardiac motion artefact; be confused with intracardiac thrombus, or be misinterpreted as a normal/anatomical finding. We present an interesting case report of asymptomatic intracardiac melanoma metastases, initially identified on staging 18-fludeoxyglucose positron emission tomography-CT and eventually confirmed on cardiac MRI. The latter was able to differentiate myocardial metastases from tumour thrombus. We also review the relevant literature.
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PMID:Intracardiac melanoma metastases on 18F-FDG PET-CT-a case report and review of literature with imaging features. 3155 72

Metastatic cancer that involves the structures of the heart is a rare complication and most commonly diagnosed during postmortem examination. Classically, the development of secondary tumors involves invasion of the pericardium or the myocardium and may disrupt the cardiac conduction system, causing new arrhythmias and heart failure. In this article, we present the case of a 58-year-old female with new diagnosis of ventricular bigeminy, and evidence of cardiac tamponade physiology from direct compression of the right ventricular outflow tract from high-grade carcinoma of the left breast. As oncologic therapies advance and provide more life-prolonging options to patients, recognition of the mass effect of large tumors should be recognized.
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PMID:Poorly Differentiated Breast Adenocarcinoma as a Rare Cause of Right Ventricular Outflow Tract Compression: Case Report and Review of the Literature. 3243 15


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