Surgical correction of cardiac metastases from cervical cancer

Metastases to the heart are extremely rare, and the reported incidence of cardiac metastasis at autopsy ranges from 1.5 to 21.8 %. In cancer patients, cardiac metastases are usually difficult to diagnose unless the patients do not complain of any related symptoms. Common tumors with cardiac metastasis potential are usually carcinomas of the lung, breast, and malignant lymphoma. The prognosis of a metastatic heart tumor is unfavorable. The average life expectancy for patients with this diagnosis is less than six months. In addition, surgical treatment of primary cardiac tumors or metastatic cardiac tumors is associated with high risk of perioperative lethality. Case report. We present a rare case of cervical cancer metastasis to the heart in a 33-year-old woman. Cytological examination revealed no evidence of disease recurrence 14 months after the completion of external beam radiotherapy. Echocardiography showed a mass in the outflow tract of the right ventricle and findings of severe pulmonary hypertension. Computed tomography and magnetic resonance imaging revealed a large right ventricular thrombus. The patient underwent surgery with artificial circulation. Pathohistological and immunohistochemical studies revealed metastasis of squamous cell carcinoma. The control echocardiography showed decrease in pulmonary hypertension. No evidence of right ventricular mass was detected. Conclusion. Cardiac metastasis should be included in the differential diagnosis in patients with complaints of dyspnea and chest pain, especially in cases with history of cancer. Surgical treatment of cardiac metastasis contributes to the prevention of cardiopulmonary complications and improvement of survival rates in this group of patients.