SURGICAL CORRECTION OF CARDIAC METASTASES FROM CERVICAL CANCER
https://doi.org/10.21294/1814-4861-2018-17-3-109-114
Abstract
Metastases to the heart are extremely rare, and the reported incidence of cardiac metastasis at autopsy ranges from 1.5 to 21.8 %. In cancer patients, cardiac metastases are usually difficult to diagnose unless the patients do not complain of any related symptoms. Common tumors with cardiac metastasis potential are usually carcinomas of the lung, breast, and malignant lymphoma. The prognosis of a metastatic heart tumor is unfavorable. The average life expectancy for patients with this diagnosis is less than six months. In addition, surgical treatment of primary cardiac tumors or metastatic cardiac tumors is associated with high risk of perioperative lethality. Case report. We present a rare case of cervical cancer metastasis to the heart in a 33-year-old woman. Cytological examination revealed no evidence of disease recurrence 14 months after the completion of external beam radiotherapy. Echocardiography showed a mass in the outflow tract of the right ventricle and findings of severe pulmonary hypertension. omputed tomography and magnetic resonance imaging revealed a large right ventricular thrombus. The patient underwent surgery with artificial circulation. Pathohistological and immunohistochemical studies revealed metastasis of squamous cell carcinoma. The control echocardiography showed decrease in pulmonary hypertension. No evidence of right ventricular mass was detected. Conclusion. Cardiac metastasis should be included in the differential diagnosis in patients with complaints of dyspnea and chest pain, especially in cases with history of cancer. Surgical treatment of cardiac metastasis contributes to the prevention of cardiopulmonary complications and improvement of survival rates in this group of patients.
About the Authors
V. M. ShipulinRussian Federation
111a, Kievskaya Street, 634012-Tomsk, Russia
2, Moskovsky trakt, 634050-Tomsk, Russia
MD, PhD, Professor, Head of Cardiovascular Surgery Department, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences (Tomsk, Russia). Author ID (Scopus): 7004309366. ResearcherID: L-6852-2016
S. L. Andreev
Russian Federation
111a, Kievskaya Street, 634012-Tomsk, Russia
MD, PhD, Senior Researcher, Cardiovascular Surgery Department, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences (Tomsk, Russia). ResearcherID: I-1681-2017
A. S. Pryakhin
Russian Federation
111a, Kievskaya Street, 634012-Tomsk, Russia
MD, Postgraduate, Cardiovascular Surgery Department, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences (Tomsk, Russia). ResearcherID: R-4187-2017
V. V. Shipulin
Russian Federation
111a, Kievskaya Street, 634012-Tomsk, Russia
MD, Physician, Laboratory of Nuclear Medicine, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences (Tomsk, Russia). ResearcherID: J-1753-2017
L. N. Bondar
Russian Federation
111a, Kievskaya Street, 634012-Tomsk, Russia
MD, Pathologist, Department of General and Molecular Pathology, Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences (Tomsk, Russia). ResearcherID: F-3622-2017
K. V. Zavadovsky
Russian Federation
111a, Kievskaya Street, 634012-Tomsk, Russia
MD, PhD, DSc, Head of Nuclear Medicine Department, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences (Tomsk, Russia). ResearcherID: F-9990-2014. Author ID (Scopus): 6504531243
V. Yu. Usov
Russian Federation
111a, Kievskaya Street, 634012-Tomsk, Russia
MD, PhD, Professor, Head of Diagnostic Imaging Department, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences (Tomsk, Russia). ResearcherID: R-4187-2017
V. M. Perelmuter
Russian Federation
5, Kooperativny street, 634009-Tomsk, Russia
MD, PhD, Professor, Head of Department of General and Molecular Pathology, Cancer Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences (Tomsk Russia). Author ID (Scopus): 8091317300
B. N. Kozlov
Russian Federation
111a, Kievskaya Street, 634012-Tomsk, Russia
2, Moskovsky trakt, 634050-Tomsk, Russia
MD, PhD, DSc, Head of Cardiac Surgery Department № 1, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences (Tomsk Russia). ResearcherID: J-1761-2017
References
1. Al-Ebrahim K. Coronary Sinus Metastasis from Cervical Carcinoma. J Card Surg. 2013 Jan; 28 (1): 22–4. doi: 10.1111/jocs.12041.
2. Senzaki H., Uemura Y., Yamamoto D., Kiyozuka Y., Ueda S., Izumi H., Tsubura A. Right intraventricular metastasis of squamous cell carcinoma of the uterine cervix: an autopsy case and literature review. Pathol Int. 1999 May; 49 (5): 447–52.
3. Jann H., Wertenbruch T., Pape U., Ozcelik C., Denecke T., Mehl S., Wiedenmann B., Pavel M. A matter of the heart: myocardial metastases in neuroendocrine tumors. Horm Metab Res. 2010 Dec; 42 (13): 967–76. doi: 10.1055/s-0030-1267204.
4. Lam K.Y., Dickens P., Chan A.C. Tumors of the heart. A 20-year experience with a review of 12,485 consecutive autopsies. Arch Pathol Lab Med. 1993 Oct; 117 (10): 1027– 31.
5. Byun S.W., Park S.T., Ki E.Y., Song H., Hong S.H., Park J.S. Intracardiac metastasis from known cervical cancer: a case report and literature review. World J Surg Oncol. 2013 May 23; 11: 107. doi: 10.1186/1477-7819-11-107.
6. Malashenkov A.I., Kavsadze V.Je. Surgery of heart tumors. Moscow: Medicina, 2004. 94. [in Russian]
7. Kalabanova E.A., Nerodo G.A., Gus’kova E.A., RozenkoL.Ja. To the question of metastasis and recurrence in cervical cancer. Siberian Journal of Oncology. 2009; Suppl. 1: 87–88. [in Russian]
8. Nakao Y., Yokoyama M., Yasunaga M., Hara K., Nakahashi H., Iwasaka T. Metastatic tumor extending through the inferior vena cava into the right atrium: a case report of carcinoma of the uterine cervix with para-aortic lymph node metastases. Int J Gynecol Cancer. 2006 Mar-Apr; 16 (2): 914–6. doi: 10.1111/j.1525-1438.2006.00230.x
Review
For citations:
Shipulin V.M., Andreev S.L., Pryakhin A.S., Shipulin V.V., Bondar L.N., Zavadovsky K.V., Usov V.Yu., Perelmuter V.M., Kozlov B.N. SURGICAL CORRECTION OF CARDIAC METASTASES FROM CERVICAL CANCER. Siberian journal of oncology. 2018;17(3):109-114. (In Russ.) https://doi.org/10.21294/1814-4861-2018-17-3-109-114