Nakashima Yasuteru, Tanioka Katsutoshi, Kubo Toru, Yamasaki Naohito, Yamasaki Ichiro, Syuin Taro, Kitaoka Hiroaki
Department of Cardiology, Neurology and Aging Science, Kochi Medical School, Kochi University, Oko-cho, Nankoku-city, Kochi, 783-8505, Japan.
Department of Urology, Kochi Medical School, Kochi University, Oko-cho, Nankoku-city, Kochi, 783-8505, Japan.
J Med Case Rep. 2015 Nov 16;9:257. doi: 10.1186/s13256-015-0740-3.
Cardiac metastasis of urothelial carcinoma is a very rare but clinically important complication. Most cardiac metastases are asymptomatic; symptoms from cardiac metastasis were seen in advanced stage and many of these cases were reported to have a poor prognosis. So it is important to find asymptomatic cardiac metastasis and to start chemotherapy early in order to improve the patient's prognosis.
A 73-year-old Asian man was referred to our hospital because of a right ventricular tumor. He had a history of left ureteral cancer 9 years ago. In screening echocardiography for paroxysmal atrial fibrillation, a low echogenic tumor was detected in his right ventricular apex, and characteristic ST segment elevation was detected in electrocardiography. An (18)F-fluorodeoxyglucose positron emission tomography revealed abnormal uptake in his right ventricular apex tumor and prostate, and a biopsy of the prostatic tumor showed urothelial carcinoma cells. He received systemic gemcitabine, paclitaxel and cisplatin chemotherapy for the urothelial carcinoma, and the cardiac tumor size was reduced temporarily. Finally, he died of multiple organ failure 16 months after his first admission, but his survival period was relatively longer than previous reports.
We experienced a case of a metastatic cardiac tumor from urothelial carcinoma. We found asymptomatic cardiac metastasis by screening echocardiography and electrocardiography. Our patient received systemic chemotherapy and his survival period was relatively longer than previous reports. Electrocardiography and echocardiography may be useful to find asymptomatic cardiac metastasis of neoplasms.
尿路上皮癌的心脏转移是一种非常罕见但具有临床重要性的并发症。大多数心脏转移是无症状的；心脏转移的症状在晚期出现，并且据报道许多此类病例预后较差。因此，发现无症状的心脏转移并尽早开始化疗以改善患者预后很重要。
一名73岁的亚洲男性因右心室肿瘤被转诊至我院。他9年前有左输尿管癌病史。在对阵发性心房颤动进行的超声心动图筛查中，在其右心室心尖发现一个低回声肿瘤，心电图检测到特征性ST段抬高。氟脱氧葡萄糖正电子发射断层扫描显示其右心室心尖肿瘤和前列腺有异常摄取，前列腺肿瘤活检显示为尿路上皮癌细胞。他接受了针对尿路上皮癌的吉西他滨、紫杉醇和顺铂全身化疗，心脏肿瘤大小暂时缩小。最终，他在首次入院16个月后死于多器官功能衰竭，但他的生存期比以前的报道相对更长。
我们遇到了一例尿路上皮癌心脏转移瘤病例。我们通过超声心动图和心电图筛查发现了无症状的心脏转移。我们的患者接受了全身化疗，其生存期比以前的报道相对更长。心电图和超声心动图可能有助于发现肿瘤的无症状心脏转移。
