Advertisement

Secondary Cardiac Tumors

  • Chiara Lestuzzi
  • Carlos A. Roldan
Chapter

Abstract

Secondary cardiac tumors are tumors originating in other organs/tissues that extend to the heart. The primary tumor may be localized within the thorax (lung and mediastinal tumors), below the diaphragm (renal carcinoma), or be extrathoracic (breast carcinoma). The most common malignancies extending to the heart are lung carcinomas (35–40 %), hematologic malignancies (10–20 %), and breast carcinomas (10 %). Other various types constitute about 30 %. Cardiac metastases reach the heart through the inferior or superior vena cava, the coronary arteries, and the lymphatic vessels or by continuity. The most frequent site of cardiac metastases is the pericardium. A pericardial effusion is a rather frequent finding in patients with cancer and may be secondary to pericardial metastases, lymphatic obstruction, or cancer treatment (mostly radiation therapy); about 65–70 % of pericardial effusions in cancer patients are due to metastases. The most frequent causes of neopalstic pericarditis are lung and breast cancer. The most common tumors causing myocardial metastasis are hematologic malignancies, breast carcinoma, and sarcomas. Endocavitary tumors reach the heart more commonly through the inferior vena cava: often these metastases are a mix of tumor and thrombus. The most common endocavitary metastases are due to renal, hepatic, or gynecologic carcinomas.

References

  1. 1.
    Bussani R, De-Giorgio F, Abbate A, Silvestri F. Cardiac metastases. J Clin Pathol. 2007;60:27–34.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Goldberg AD, Blankstein R, Padera RF. Tumor metastatic to the heart. Circulation. 2013;128:1790–4.CrossRefPubMedGoogle Scholar
  3. 3.
    Kraft C, Schuettfort G, Weil Y, et al. Thrombosis of the inferior vena cava and malignant disease. Thromb Res. 2014;134(3):668–73.CrossRefPubMedGoogle Scholar
  4. 4.
    Debourdeau P, Gligorov J, Teixeira L, Aletti M, Zammit C. Tumeurs cardiaques malignes (Malignant cardiac tumors). Bull Cancer. 2004;91:S136–46.Google Scholar
  5. 5.
    Lestuzzi C. Neoplastic pericardial disease: old and current strategies for diagnosis and management. World J Cardiol. 2010;2:270–9.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Jacob S, Sebastian JC, Cherian PK, Abraham A, John SK. Pericardial effusion impending tamponade: a look beyond Beck's triad. Am J Emerg Med. 2009;27(2):216–9.CrossRefPubMedGoogle Scholar
  7. 7.
    Roldan CA. Pericardial diseases. In: Roldan CA, editor. The ultimate echo guide. Lippincott: Philadelphia; 2012. p. 320–39.Google Scholar
  8. 8.
    Lestuzzi C. Epidemiology, diagnosis and therapy of neoplastic pericarditis. J Cardiovasc Echogr. 2011;21(2):86–91.CrossRefGoogle Scholar
  9. 9.
    Pawlak Cieślik A, Szturmowicz M, Fijałkowska A, et al. Diagnosis of malignant pericarditis: a single centre experience. Kardiol Pol. 2012;70:1147–53.PubMedGoogle Scholar
  10. 10.
    L'italien AJ. Critical cardiovascular skills and procedures in the emergency department. Emerg Med Clin North Am. 2013;31:151–206.CrossRefPubMedGoogle Scholar
  11. 11.
    Loukas M, Walters A, Boon JM, Welch TP, Meiring JH, Abrahams PH. Pericardiocentesis: a clinical anatomy review. Clin Anat. 2012;25:872–81. Review.CrossRefPubMedGoogle Scholar
  12. 12.
    Pepi M, Muratori M. Echocardiography in the diagnosis and management of pericardial disease. J Cardiovasc Med (Hagerstown). 2006;7:533–44. Review.CrossRefGoogle Scholar
  13. 13.
    Klein SV, Afridi H, Agarwal D, Coughlin BF, Schielke LH. CT directed diagnostic and therapeutic pericardiocentesis: 8-year experience at a single institution. Emerg Radiol. 2005;11:353–63.CrossRefPubMedGoogle Scholar
  14. 14.
    Hoey ET, Mankad K. Computed tomography-guided pericardiocentesis: utility in the management of malignant pericardial effusion. Am J Emerg Med. 2010;28:388.e1–3.CrossRefGoogle Scholar
  15. 15.
    Jeon HW, Cho DG, Park JK, et al. Prognostic factors affecting survival of patients with cancer-related pericardial effusion managed by surgery. World J Surg Oncol. 2014;12:249.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Ruiz-García J, Jiménez-Valero S, Moreno R, et al. Percutaneous balloon pericardiotomy as the initial and definitive treatment for malignant pericardial effusion. Rev Esp Cardiol (Engl Ed). 2013;66:357–63.CrossRefGoogle Scholar
  17. 17.
    Celik S, Lestuzzi C, Cervesato E, et al. Systemic chemotherapy in combination with pericardial window has better outcomes in malignant pericardial effusions. J Thorac Cardiovasc Surg. 2014;148:2288–93.CrossRefPubMedGoogle Scholar
  18. 18.
    Patel N, Rafique AM, Eshaghian S, et al. Retrospective comparison of outcomes, diagnostic value, and complications of percutaneous prolonged drainage versus surgical pericardiotomy of pericardial effusion associated with malignancy. Am J Cardiol. 2013;112:1235–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Lestuzzi C, Bearz A, Lafaras C, et al. Neoplastic pericardial disease in lung cancer: impact on outcomes of different treatment strategies. A multicenter study. Lung Cancer. 2011;72:340–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Lestuzzi C, Nicolosi GL, Biasi S, Piotti P, Zanuttini D. Sensitivity and specificity of electrocardiographic ST-T changes as markers of neoplastic myocardial infiltration. Echocardiographic correlation. Chest. 1989;95:980–5.CrossRefPubMedGoogle Scholar
  21. 21.
    Kokudo T, Hasegawa K, Yamamoto S, et al. Surgical treatment of hepatocellular carcinoma associated with hepatic vein tumor thrombosis. J Hepatol. 2014;61:583–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Goto H, Hashimoto M, Akamatsu D, et al. Surgical resection and inferior vena cava reconstruction for treatment of the malignant tumor: technical success and outcomes. Ann Vasc Dis. 2014;7:120–6.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    George J, Grebenik K, Patel N, Cranston D, Westaby S. The importance of intraoperative transoesophageal monitoring when operating on renal cancers that involve the right atrium. Ann R Coll Surg Engl. 2014;96:e18–9.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Cardiology UnitAviano (PN)Italy
  2. 2.University of New Mexico School of Medicine and VA Medical CenterAlbuquerqueUSA

Personalised recommendations