Large left ventricular metastasis causing left ventricular outflow tract obstruction and haemolysis

Sarcomas of the heart as a difficult interdisciplinary problem

Cardiac tumors are assumed to be a rare entity. Metastases to the heart are more frequent than primary lesions. Sarcomas make up the majority of cardiac malignant neoplasms. Among them angiosarcoma is the most common and associated with the worst prognosis. Malignant fibrous histiocytoma comprises the minority of cardiac sarcomas and has uncertain etiology as well as pathogenesis. Transthoracic echocardiography remains the widely available screening examination for the initial diagnosis of a cardiac tumor. The clinical presentation is non-specific and the diagnosis is established usually at an advanced stage of the disease. Sarcomas spread preferentially through blood due to their immature vessels without endothelial lining. Surgery remains the method of choice for treatment. Radicalness of the excision is still the most valuable prognostic factor. Adjuvant therapy is unlikely to be effective. The management of cardiac sarcomas must be individualized due to their rarity and significant differences in the course of disease.

Direct Left Ventricular Metastasis Reduction: 3D-Echo Monitoring For Management of Clinical Case

A 52-year-old woman with a lung carcinoma metastatic to bone was admitted to the Cardiology Department for acute chest pain after 1 week of the oncologic therapy. Electrocardiographic examination (ECG) revealed ischemic picture with ST-T wave abnormalities in DI and aVL leads and poor progression of R wave in V1-V4 leads. Two- and three-dimensional transthoracic echocardiography (2D/3D TTE) showed myocardial involvement with infiltration of the anterolateral left ventricular (LV) wall from the epicardial to the endocardial layer, apical hypokinesia, LV ejection fraction (LVEF) and global 3D longitudinal strain reduction, but was absent pericardial effusion. Three months from the beginning of erlotinib, the patient showed a significant reduction in myocardial involvement with no ECG-ST elevation. Echo showed a mild regression of the wall infiltration and a slightly improvement of LVEF and strain. A computed tomography (CT) scan showed partial remission of the primary lung lesion, intracavitary and intramyocardial mass.

Removal of the left atrium and left ventricle tumour: a case report

The heart is the rarest site for neoplasms to be localized. Despite modern diagnostic techniques, cardiac tumours continue to among those discovered latest and with the worst prognoses. We present the case of a 62-year-old woman with a heart tumour and mediastinal lymphadenopathy, who was admitted to the Department of Cardiac Surgery. The patient underwent surgical removal of the tumour with extracorporeal circulation. The left atrium, mitral valve and the left ventricle were occupied by the infiltration. A radical resection appeared to be impossible. A valvular prosthesis was not implanted. The perioperative period was uncomplicated. On the 9(th) day a local recurrence was confirmed in the transthoracic echocardiography. Further oncological diagnostics revealed the spread of the malignant neoplasm to bones of the pelvis and spine. Chemotherapy was initiated. The authors discuss the most appropriate diagnostic and treatment procedures employed in the above case.

Uncommon cause of obstruction in the left ventricular outflow tract by a metastasis of adenocarcinoma

Cardiac metastases are rare diagnoses among cardiac disorders. This case demonstrates a unique presence of an obstruction in the left ventricular outflow tract caused by the metastasis of a renal carcinoma. Adequate diagnostic and therapeutic procedures were lifesaving in this potentially fatal diagnosis.