Fiala W, Schneider J
Schweiz Med Wochenschr. 1982 Oct 23;112(43):1497-501.
In contrast to their clinical manifestation, metastases to the heart are not rare findings at autopsy. In one of five patients dying from metastatic cancer, spread to the heart is found. The incidence of metastatic involvement of the heart depends on the type of cancer, malignant melanoma and leukemia being the most frequent and metastases of carcinoma less so. The primary carcinomas metastasizing to the heart are most often situated near it, which may indicate that lymphatic channels are infiltrated in a retrograde manner from metastatic deposits in mediastinal lymph nodes. The fact that metastasis of primary carcinoma in the vicinity of the heart lodge predominantly in the epicardium supports this concept. On the other hand, it appears easier to explain the frequency and distribution of cardiac metastases from carcinomas of the abdominal cavity by assuming that they are bloodborne. Hence it is assumed that the routes of disseminated of tumor cells to the heart are through lymphatic as well as blood vessels.
与临床表现相反，心脏转移在尸检中并非罕见发现。在死于转移性癌症的患者中，五分之一的患者会出现心脏转移。心脏转移受累的发生率取决于癌症类型，恶性黑色素瘤和白血病最为常见，而癌转移相对较少。转移至心脏的原发性癌最常位于心脏附近，这可能表明肿瘤细胞是从纵隔淋巴结的转移性沉积物逆行浸润淋巴管的。原发性癌在心脏附近的转移主要位于心外膜这一事实支持了这一观点。另一方面，假设腹腔癌的心脏转移是血行性的，似乎更容易解释其发生频率和分布情况。因此，推测肿瘤细胞向心脏播散的途径是通过淋巴管和血管。
