A Case of Pericardial Metastasis: Image Case Report

Mahmoud H Abdelnaby; Abdallah M Almaghraby; Ashraf A El-Amin

doi:10.21767/2576-1455.1000113

A Case of Pericardial Metastasis: Image Case Report

Mahmoud H Abdelnaby¹, Abdallah M Almaghraby² and Ashraf A El-Amin²

¹Cardiology and Angiology Unit, Department of Clinical and Experimental Internal Medicine, Medical Research Institute, University of Alexandria, Alexandria, Egypt

²Department of Cardiology, University of Alexandria, Alexandria, Egypt

*Corresponding Author:: Mahmoud H Abdelnaby
Cardiology and Angiology Unit
Department of Clinical and Experimental Internal Medicine
Medical Research Institute, University of Alexandria, Egypt
Tel: +201007573530
E-mail: Mahmoud.hassan.abdelnabi@outlook.com

Received Date: 22 January 2018; Accepted Date: 06 February 2018; Published Date: 15 February 2018

Citation: Abdelnaby MH, Almaghraby AM, El-Amin AA (2018) A Case of Pericardial Metastasis: Image Case Report. J Heart Cardiovasc Res. Vol.2 No.1:1

Copyright: © 2018 Abdelnaby MH, et al. This is an open-access article distributed under the terms of the creative Commons attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

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Abstract

A 76-year-old male with a past history of resected cancer colon and a recurrence in the form of hepatic and lung metastases had a Chest X Ray (CXR) which revealed cardiomegaly and referred for echocardiography that revealed a large pericardial mass with pericardial effusion most likely metastatic in nature.

Keywords

Pericardium; Metastasis; Cancer colon

Introduction

Although primary cardiac tumors are extremely rare, secondary tumors are not. Theoretically the heart can be metastasized by any malignant neoplasm able to spread to distant sites.

Case Presentation

A 76-year-old male patient with past medical history of diabetes, hypertension, ischemic heart disease and chronic renal failure on maintenance hemodialysis and a history of resected adenocarcinoma of the colon 2 years ago with recurrence diagnosed 6 months ago in the form of hepatic and pulmonary metastases had a CXR which revealed cardiomegaly and bilateral pulmonary infiltrates. He was referred for echocardiography which showed a large fleshy pericardial mass attached to the anterior surface of the right atrium and ventricle with anterior pericardial effusion most likely metastatic in nature. Due to his critical condition, no further investigations were done and only supportive and palliative measures were adopted (Figures 1 and 2).

heart-cardiovascular-research-subcostal-view-large

Figure 1: Subcostal view showing a large anteriorly located pericardial mass with anterior pericardial effusion (A and B).

heart-cardiovascular-research-apical-chamber-view

Figure 2: Apical 4 chamber view showing a large pericardial mass related to the right atrium and ventricle with mild pericardial effusion.

Discussion and Conclusion

Primary pericardial malignancies are extremely rare [1]. Metastases to the heart and pericardium are much more common than primary cardiac tumors and are generally associated with a poor prognosis [2]. Echocardiography remains the key method for diagnosis of cardiac masses [3]. Advances in other imaging modalities such as Cardiac Magnetic Resonance (CMR) and Cardiac Computed Tomography (CT) are associated with improved tissue characterization with better spatial and temporal resolutions [4].

References

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Hoffmeier A, Sindermann JR, Scheld HH, Martens S (2014) Cardiac tumors-diagnosis and surgical treatment. Deutsches Ärzteblatt international 111: 205.
Mankad R, Herrmann J (2016) Cardiac tumors: Echo assessment. Echo research and practice 3: R65-R77.
Motwani M, Kidambi A, Herzog BA, Uddin A, Greenwood JP, et al. (2013) MR imaging of cardiac tumors and masses: A review of methods and clinical applications. Radiology 268: 26-43.