Ngow Harris A, Khairina W M N Wan
Department of Medicine, International Islamic University Malaysia, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia.
Cardiovasc J Afr. 2012 Aug 12;23(7):e10-2. doi: 10.5830/CVJA-2012-027.
Cardiac metastasis from a bowel malignancy seldom occurs and there is a limited number of case reports published on this subject. Although colorectal cancer is the third commonest malignancy in Malaysia, the incidence of cardiac metastasis has never been reported. We report a case of an elderly man with recently diagnosed adenocarcinoma of the sigmoid colon, who presented with congestive cardiac failure secondary to mechanical obstruction by a right atrial mass. The intractable shock led to his sudden death before any intervention could be planned. If an intra-cavity cardiac mass is detected in a patient with an underlying metastatic malignancy, cardiac metastasis should be suspected. However, primary cardiac tumour or thrombus could also be the differential diagnosis. In our case, the definitive cardiac pathology remained unsolved as an autopsy was refused.
肠道恶性肿瘤的心脏转移很少见，关于这一主题发表的病例报告数量有限。尽管结直肠癌是马来西亚第三常见的恶性肿瘤，但心脏转移的发生率从未有过报道。我们报告一例老年男性，近期诊断为乙状结肠癌，因右心房肿块导致机械性梗阻继发充血性心力衰竭。在能够制定任何干预措施之前，顽固性休克导致他突然死亡。如果在患有潜在转移性恶性肿瘤的患者中检测到心腔内肿块，应怀疑心脏转移。然而，原发性心脏肿瘤或血栓也可能是鉴别诊断。在我们的病例中，由于家属拒绝尸检，最终的心脏病理诊断仍未明确。
