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Successful treatment of metastatic cardiac lymphoma with complete A-V block
E Takeuchi1, H Yanagawa, N Nishikubo
1Third Department of Internal Medicine, University of Tokushima School of Medicine, Japan. takeuchi@clin.med.tokushima-u.ac.jp
Insights
Metastatic cardiac lymphoma, though often found postmortem, can be successfully treated. Early diagnosis and a combination of surgery, chemotherapy (cyclophosphamide, doxorubicin, vincristine, predonisolone), and radiation therapy can lead to long-term survival.
Area of Science:
- Cardiology
- Oncology
- Pathology
Background:
- Malignant lymphoma can infiltrate the heart, but diagnosis is frequently delayed until autopsy.
- Cardiac lymphoma presents a diagnostic challenge, often with advanced disease at presentation.
Observation:
- A case of metastatic cardiac lymphoma presenting with complete atrioventricular (A-V) block is described.
- The patient exhibited symptoms of heart failure secondary to the cardiac tumor.
Findings:
- Successful treatment was achieved through surgical resection of the heart tumor.
- Sequential combination chemotherapy (cyclophosphamide, doxorubicin, vincristine, predonisolone) and radiation therapy were administered.
- The multimodal approach resulted in complete resolution of heart failure symptoms and A-V block.
Implications:
- This case highlights the importance of early diagnosis in managing metastatic cardiac lymphoma.
- Combination therapy, including surgery, chemotherapy, and radiation, offers a promising strategy for long-term survival in these patients.
- Aggressive, multimodal treatment can reverse severe cardiac dysfunction caused by lymphoma.
Abstract:
Although involvement of the heart is not a rare manifestation of malignant lymphoma, most cases are diagnosed by postmortem examination. In the present article, we describe a man with metastatic cardiac lymphoma with complete A-V block successfully treated by resection of the heart tumor and sequential combination chemotherapy with cyclophosphamide, doxorubicin, vincristine and predonisolone and radiation therapy. Combination modality resulted in complete disappearance of signs of heart failure and A-V block. Our experience indicated that early diagnosis and combination modality can obtain long survival in case of metastatic cardiac lymphoma.