Cardiac Septal Metastasis From Poorly Differentiated Colorectal Adenocarcinoma: A Rare Case Illustrating the Role of...

Cardiac metastases from colorectal adenocarcinoma are rare and may present with varied or absent symptoms.

A middle-aged woman with recurrent colorectal adenocarcinoma presented with an infiltrating ventricular septal cardiac mass. Multimodal imaging, including PET-CT and cardiac MRI, was crucial for both identifying the lesion as a metastasis and for subsequent serial monitoring. Extensive cardiac involvement necessitated specialized surgical and radiation oncology expertise at a high-volume center, though extra-cardiac lesions led to deferring surgery or radiation as therapeutic options. Ultimately, lesion regression was achieved with intensive chemotherapy and immunotherapy targeting the primary malignancy.

To our knowledge, no prior cases have documented colorectal adenocarcinoma metastasizing to the interventricular septum with interatrial extension. Management of intracardiac metastases is complex and requires a multidisciplinary approach.

Accurate diagnosis and characterization of cardiac masses requires a multimodal imaging approach, while effective management depends on a multidisciplinary strategy tailored to treatment goals and patient-specific factors. Surgical resection can be considered at high-volume centers but may be deferred in metastatic disease if it does not improve prognosis or symptoms. Factoring in the expected response to medical therapy is also important.