Cardiac metastasis from a urothelial cell carcinoma: a commented case report

We present a case of a middle-aged male patient who was admitted to our institution because of the supposed diagnosis of endocarditis/myocarditis. Echocardiographic findings revealed cystic mass in the left myocardial wall as well as floating structures at the lateral papillary muscle, mimicking endocarditis/myocarditis. Due to progressive urinary retention and clinical signs of a beginning ileus, an abdominal and thoracic computed tomographic scan was performed, which demonstrated a large diverticle of the urinary bladder with expansive tumorous wall mass. One week later, the patient died of acute cardiorespiratory failure. On autopsy, the tumorous mass in the urinary bladder with large carcinosis of the peritoneum and multiple left and right ventricular metastases were confirmed; the histological analysis indicated a less differentiated urothelial cell carcinoma with its origin in the large diverticle of the urinary bladder with subsequent cardiac metastases.