Intracardiac Extension of Malignant Tumors: A Case Series with Seven Cases

Abstract

Despite its scarcity, malignant tumor extending to the heart is a lethal condition. Cardiac metastases are considered to occur rarely. In the present paper, we represented a single-center experience in cardiac metastases diagnosis in addition to different treatment modalities for improving the patients’ quality of life and survival. We could claim that this is the largest report of this kind to date. We retrospectively reviewed the patients’ files in our hospital, from 2009 to 2022. These patients presented with radiological/ intraoperative evidence of intracardiac extension of malignant tumor. Seven patients with transvenous intracardiac tumor extension were referred to our center. There was primary tumor in the lung in four cases (57.14%), two with synovial sarcoma (14.3%), one with renal cell carcinoma with inferior vena cava extension to the right atrium, and one with osteosarcoma. Moreover, there was one case of thymic origin (14.3%). Four patients underwent urgent surgery upon diagnosis, in order to have higher quality of life, and R0 resection which was not possible in any of them (two patients had R1 and two had R2). Among them, one received palliative chemotherapy followed by chemoradiation after debulking surgery, one received concurrent chemoradiotherapy, one received palliative chemotherapy only, and one refused to get any treatment. Survival was better in the patients who received concurrent chemoradiotherapy. According to our results, urgent/unplanned surgery could not be a good candidate for intracardiac extension of malignant tumors and does not improve survival. Combined multidisciplinary approach, on the other hand, was found to be a better option for disease control.

Keywords

• heart atria
• lung
• quality of life
• cytoreductive surgical procedures