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Case Report: Mitral valve obstruction by metastatic malignant phyllodes tumor
Chamtouri Ikram1, Amdouni Nesrine1, Kaddoussi Rania2
1cardiology B department, Fattouma Bourguiba University Hospital, Monastir, MONASTIR, 5000, Tunisia.
F1000Research
|August 16, 2022
Summary
Metastatic breast phyllodes tumor (PT) can spread to the heart, causing severe mitral valve obstruction. This rare cardiac metastasis highlights the aggressive nature of malignant PT and the need for vigilant monitoring.
Area of Science:
- Cardiology
- Oncology
- Pathology
Background:
- Cardiac metastases are uncommon, posing diagnostic and therapeutic challenges.
- Phyllodes tumors (PT) of the breast are rare biphasic tumors with a spectrum of behavior, ranging from benign to malignant.
- Malignant PT can exhibit aggressive behavior and metastasize to distant organs.
Observation:
- A case of a 37-year-old female with borderline breast phyllodes tumor (PT) treated surgically.
- The patient presented with concomitant cardiac and pulmonary metastases from malignant PT.
- Cardiac metastasis occurred via direct extension from pulmonary metastasis to the left atrium through the right inferior pulmonary vein.
Findings:
- The cardiac metastasis resulted in severe mitral valve obstruction.
- Despite complete surgical removal of metastases, a significant relapse of mediastinal metastasis occurred.
- The patient ultimately succumbed to the disease progression.
Implications:
- This case underscores the potential for malignant PT to metastasize to the heart, even after initial surgical management.
- Direct extension from pulmonary metastases to the heart is a possible pathway for cardiac involvement.
- The findings emphasize the importance of thorough staging and long-term surveillance in patients with malignant PT, particularly those with pulmonary involvement.
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