cardiac metastasis

cardiac metastasis

The indirect—haematogenous, lymphatic or other non-contiguous—development of a malignant tumour in the heart or its surroundings. Neoplastic effusions are more often haemorrhagic, and most commonly affect the pericardium. Primary heart tumours are rare—between 0.001% and 0.28%. Metastases to the heart are found in up to 18% of post mortems of patients who die with cancer.

Common primary tumours
Pleural mesothelioma, melanoma, mediastinal primary tumours.

Effects
Nonspecific conduction defects and arrhythmias, cardiac dysfunction and heart failure due to pericardial effusion, intramural oedema due to lymphatic outflow, filling impairment due to endocardial involvement, and direct myocardial invasion.

Sites of origin (“donors”)
Endocardium Lung, kidney and hepatocellular carcinomas
Myocardium Leukaemia and lymphoma
Pericardium Lungs
Vena cava Renal and hepatocellular carcinomas
References in periodicals archive ?
Although primary cardiac tumors are rare, cardiac metastasis of malignant tumors is not as infrequent as we might suspect.
Cardiac metastasis of transitional cell carcinoma has been previously reported in the right ventricle, left atrium, and pericardium.
Although he had not received treatment for his metastatic melanoma, heart failure due to obstructive cardiac metastasis is generally a poor prognostic indicator.
Cardiac metastasis of other primary tumours would be 20 to 30 times more frequent.
Canova et al., "Isolated cardiac metastasis from squamous cell esophageal cancer," Tumori, vol.
Cardiac metastasis from a bronchial carcinoid: report of a case presenting with diffuse thickening of the left ventricular wall.
In one reported case, (23) the first and only cardiac manifestation of cardiac metastasis of lung cancer was irreversible, sustained, ventricular arrhythmia leading to death.
The incidence of cardiac metastasis has been reported to be 2.3% and 18.3% of autopsied cases of carcinoma.[sup.1,2] It has been reported that 10% of autopsied cases of urothelial carcinoma (UC) exhibited cardiac metastases.[sup.3] However, the metastases are clinically silent in most cases.
We present a case in which the clear identification of the primary tumour and cardiac metastasis altered the surgical management and avoided a high-risk anaesthetic.
(21) Cardiac metastasis is typically associated with widely disseminated disease.
Cardiac metastasis by malignant tumors is uncommon, with a prevalence ranging from 0.4% to 20.6%.(1)(2)(3) Primary tumors that most commonly metastasize to the heart are lung, breast, melanoma, and sarcoma.(1)(2) Gastric cancers uncommonly metastasize to the heart, with a reported prevalence of approximately 2.8%.(1) Metastasis to the heart can occur by hematologic dissemination (embolism of tumor cells), by lymphatic invasion, or by direct extension, as often occurs with a lung cancer invading the heart.