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Cardiac metastasis from colorectal cancer: a case report
Pyong Wha Choi1, Chul Nam Kim, Sun Hee Chang
1Department of Surgery, Inje University College of Medicine, Ilsan Paik Hospital, 2240 Daehwa-dong, Ilsanseo-gu, Goyang-si, Gyeonggi-do, 411-806, Goyang, South Korea. eacechoi@hanmail.net
Insights
Cardiac metastasis from colorectal cancer is rare. This case highlights a patient with sigmoid colon cancer who developed a right atrial mass, confirmed as adenocarcinoma metastasis.
Area of Science:
- Oncology
- Cardiology
- Pathology
Background:
- Cardiac metastasis is uncommon across all malignancies.
- Colorectal cancer rarely metastasizes to the heart.
Observation:
- A 70-year-old woman presented with sigmoid colon cancer and a suspected cardiac myxoma.
- Echocardiography and CT revealed a mobile mass in the right atrium.
- The mass was histologically confirmed as adenocarcinoma, matching the primary colorectal tumor.
Findings:
- The patient underwent successful resection of both the colon and cardiac masses.
- Post-operative diagnosis confirmed cardiac metastasis from colorectal adenocarcinoma.
- The patient experienced shortness of breath, necessitating cardiac surgery.
Implications:
- This case underscores the importance of considering metastasis in cardiac masses, especially in cancer patients.
- While echocardiography is key for cardiac tumor detection, advanced imaging like MRI may be crucial for colorectal cancer patients with cardiac masses.
- Early diagnosis and integrated treatment strategies are vital for managing rare metastatic presentations.
Abstract:
The heart is an unusual site of metastasis from any malignancy. We report a case of cardiac metastasis from colorectal cancer. A 70-year-old woman was referred with a presumptive diagnosis of sigmoid colon cancer with cardiac myxoma. Two-dimensional echocardiography showed a 4 cm x 4.5 cm mobile mass on the lateral right atrial wall, and computed tomography revealed a low attenuated lobulating mass in the right atrium. The patient underwent anterior resection for sigmoid colon cancer (T4N2). Thereafter, she experienced progressive shortness of breath. Therefore, a cardiac operation was performed 2 wk after the colorectal operation. Histological examination revealed adenocarcinoma, which was identical to the primary lesion. Although two-dimensional echocardiography has become the diagnostic test of choice for detecting cardiac tumors, in patients with colorectal cancer showing a cardiac mass, further diagnostic evaluation such as a magnetic resonance imaging might be necessary.
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