Nnadi Ekenedilichukwu N, Khatun Nazima, John Sabu
Internal Medicine, State University of New York Downstate Medical Center, Brooklyn, USA.
Cardiology, Kings County Hospital Center, Brooklyn, USA.
Cureus. 2024 Jun 17;16(6):e62530. doi: 10.7759/cureus.62530. eCollection 2024 Jun.
Metastasis of cervical cancer to the heart is rare. Cervical carcinoma typically spreads to the lungs, liver, bones, and lymph nodes via hematogenous, lymphatic, transvenous, or direct extension. Cardiac metastasis from cervical carcinoma is uncommon and portends a dismal prognosis, with mean survival under six months post-diagnosis. A high index of suspicion and multimodal imaging is imperative for prompt diagnosis and improved outcomes in these patients. Here, we report a rare case where a 41-year-old African American female with stage IIIB cervical squamous cell carcinoma (SCC) presented with exertional dyspnea and chest pain concerning pulmonary embolism (PE). Computed tomography angiography showed no PE but revealed a right ventricular (RV) mass and diffuse pulmonary nodules. Echocardiography suggested an RV tumor versus a thrombus. Cardiac magnetic resonance imaging demonstrated a large RV infiltrative mass favoring metastasis over thrombus. A biopsy of one of the pulmonary nodules confirmed metastatic SCC. Despite treatment, the prognosis was poor.
宫颈癌转移至心脏较为罕见。宫颈癌通常通过血行、淋巴、经静脉或直接蔓延等途径扩散至肺、肝、骨和淋巴结。宫颈癌的心脏转移并不常见,且预后不佳,诊断后平均生存期不到六个月。对于这些患者,高度的怀疑指数和多模态成像对于及时诊断和改善预后至关重要。在此,我们报告一例罕见病例,一名41岁的非洲裔美国女性,患有IIIB期宫颈鳞状细胞癌(SCC),出现劳力性呼吸困难和胸痛,怀疑为肺栓塞(PE)。计算机断层扫描血管造影显示没有PE,但发现右心室(RV)肿块和弥漫性肺结节。超声心动图提示右心室肿瘤与血栓鉴别。心脏磁共振成像显示右心室有一个大的浸润性肿块,倾向于转移而非血栓。对其中一个肺结节进行活检,证实为转移性SCC。尽管进行了治疗,但预后仍很差。