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Neoplasms metastatic to the heart: review of 3314 consecutive autopsies
K P Abraham1, V Reddy, P Gattuso
1Department of Pathology, Loyola University Medical Center, Maywood, IL 60153.
Insights
Cardiac metastasis is uncommon, often seen in widespread cancer. This study found the incidence of heart tumors from cancer has remained consistent over 14 years, unaffected by medical advancements.
Area of Science:
- Oncology
- Pathology
- Cardiology
Background:
- Cardiac involvement by metastatic neoplasms is rare, typically associated with advanced disease.
- Autopsy studies provide crucial insights into the incidence and patterns of metastatic spread.
Purpose of the Study:
- To review the incidence and characteristics of cardiac metastases over a 14-year period.
- To assess the impact of improved diagnostic and treatment protocols on cardiac metastasis rates.
Main Methods:
- Retrospective review of 95 cases with cardiac metastases from 3314 autopsies (1974-1987).
- Analysis of autopsy data to determine the frequency and primary sources of cardiac tumors.
Main Results:
- Cardiac metastasis was found in 11.8% of autopsies with malignant disease.
- Lung, lymphoma, and breast cancer were the most frequent primary sources.
- The incidence of cardiac metastasis remained stable throughout the study period.
Conclusions:
- Cardiac metastasis incidence has not significantly changed despite medical advancements.
- Early detection and treatment of primary cancers may not alter the rate of heart involvement.
Abstract:
Cardiac involvement by metastatic neoplasms is relatively uncommon and usually occurs with widely disseminated disease. Ninety-five cases with cardiac metastases from autopsies performed over a 14-year period (1974-1987) at Loyola University Medical Center are reviewed. During this period, 3314 autopsies were performed with an average annual autopsy rate of 35%. In 806 (24.3%), a malignant disease was found, and in 95 (11.8%), there was cardiac involvement by tumor. The most common malignancies encountered in order of decreasing frequency were lung, lymphoma, breast, leukemia, stomach, melanoma, liver, and colon. Although the percentage of cardiac metastasis compares favorably with previous reports in the literature, an identical rate was present during both halves of the 14-year period studied. Improved diagnostic capabilities and treatment protocols in recent years have apparently not significantly affected the incidence, distribution, or patterns of metastatic spread to the heart.