Dataset Information

Cardiac metastasis from gastric adenocarcinoma: A rare case report.

ABSTRACT:

Introduction and significance

Cardiac dissemination of gastric adenocarcinoma represents an exceedingly uncommon clinical scenario. To date, there is an absence of documentation concerning the presence of tumor emboli within the cardiac chambers originating from gastric cancer, particularly following a possible transvenous migration.

Case presentation

This report delineates the clinical journey of a 60-year-old female diagnosed with inoperable diffuse gastric adenocarcinoma, who developed cardiac metastases.

Clinical discussion

The prognostication of isolated cardiac metastasis in oncology patients is fraught with difficulty due to its infrequency and non-specific clinical manifestations. While systematic screening for cardiac metastasis is not part of standard oncological protocols, heightened vigilance is warranted in specific scenarios such as advanced-stage malignancies or in the presence of suggestive cardiac symptomatology, thereby prompting further exploration.

Conclusion

Cardiac metastasis, while infrequent, constitutes a dire clinical entity that must be contemplated in the differential diagnosis of cardiac mass presentations in individuals with a neoplastic history. Prompt recognition and deployment of appropriate diagnostic imaging are pivotal for informed therapeutic decision-making. An integrative, multidisciplinary strategy is imperative for the formulation of an optimal treatment paradigm, encompassing surgical and palliative care options.

Key clinical message

Cardiac metastasis of gastric adenocarcinoma are extremely rare, however, in gastric cancer cases with cardiopulmonary manifestation should be considered as a probable differential diagnoses.

SUBMITTER: Jahanshahi F

PROVIDER: S-EPMC11318462 | biostudies-literature | 2024 Sep

REPOSITORIES: biostudies-literature

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Publications

Cardiac metastasis from gastric adenocarcinoma: A rare case report.

Jahanshahi Fatemeh F Davani Sam ZeraatianNejad SZ Naderi Delaram D Parsaei Amirhossein A Mirahmadi Eraghi Mohammad M

International journal of surgery case reports 20240716

<h4>Introduction and significance</h4>Cardiac dissemination of gastric adenocarcinoma represents an exceedingly uncommon clinical scenario. To date, there is an absence of documentation concerning the presence of tumor emboli within the cardiac chambers originating from gastric cancer, particularly following a possible transvenous migration.<h4>Case presentation</h4>This report delineates the clinical journey of a 60-year-old female diagnosed with inoperable diffuse gastric adenocarcinoma, who d ...[more]

PMID: 39043093

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Project description:BackgroundPancreatic ductal adenocarcinoma (PDAC) accounts for 90% of all pancreatic carcinomas. Prognosis is poor with a worldwide five-year survival rate of 2-9%. Extent of metastasis is a prognostic factor. Most common metastatic sites include the liver, peritoneum, lung, and bones. We report a case of distant metastasis of PDAC to the left choroid.Case descriptionThis patient is a 59-year-old Caucasian male who initially presented with right flank pain progressing to exercise and activity impairment. Abdominal computed tomography scan showed a pancreatic tail mass subsequently confirmed as PDAC via endoscopic ultrasound with fine needle aspiration. Prior to treatment initiation, patient was referred to ophthalmology for acute vision changes. Evaluation revealed left eye pigmentary changes overlying subretinal fluid (SRF) along with peripheral retinal depigmentation indicative of choroidal metastasis. As of this report submission, patient has completed his initial 6-month course of gemcitabine/paclitaxel protein-bound/cisplatin with partial response. He remains active on his second line of chemotherapy. Visual disturbances and evidence of choroidal metastasis continue to resolve.ConclusionsPDAC is often identified at a late stage, with metastasis or local advancement identified in 80-85% of first diagnoses. This is thought to account for its poor median survival of two to eleven months. The retinal choroid is an extremely rare site of PDAC metastasis, with less than ten cases reported in literature. In this patient, the choroid was the first confirmed metastatic site and represented distant metastasis. Nevertheless, this patient continues to do well and is expected to exceed the upper bound median survival of 11 months following systemic chemotherapy. From this case, we note that distant metastasis prior to treatment initiation may not predict worse prognosis. Systemic chemotherapy was effective in both primary tumor shrinkage as well as regression of choroidal metastasis, leading to improvement in visual symptoms. This suggests that while choroidal metastasis should not be missed in patients with PDAC, systemic chemotherapy may be effective in mitigating collateral symptomatology and thus preserving quality of life.

Project description:Cervical cancer is a prevalent gynecological malignancy; however, intracavitary cardiac metastasis of cervical squamous cell carcinoma is exceptionally rare. In addition, the co-occurrence of cervical cancer and right ventricular cancer thrombus with autoimmune diseases is extremely uncommon. Furthermore, the role of immune checkpoint inhibitors in the treatment process of such cases remains controversial. Given the scarcity of reported cases, it is imperative to document and highlight this unique presentation, providing novel insights into diagnosis and management strategies. We present the case of an adult patient diagnosed with cervical cancer and concurrent right ventricular cancer thrombus, accompanied by immune thrombocytopenia (ITP). The patient exhibited resistance to conventional ITP drugs, with suboptimal platelet response. However, upon achieving initial control of the tumor, the patient's platelet counts returned to normal. Notably, the addition of immune checkpoint inhibitors targeting PD-L1 resulted in effective tumor control, accompanied by sustained high platelet levels. Unfortunately, during subsequent anti-tumor therapy, the patient experienced a prolonged platelet rise time, rendering continuous effective anti-tumor therapy and anticoagulant therapy unattainable. This led to a gradual increase in intraventricular thrombosis, ultimately resulting in the patient's demise due to circulatory failure. This rare case sheds light on the potential alleviation of ITP in patients with tumor complications through effective antitumor therapy. The successful control of ITP after tumor management highlights the importance of integrated treatment approaches. Furthermore, the inclusion of immune checkpoint inhibitors demonstrated their potential role in achieving tumor control and maintaining platelet levels. However, the prolonged platelet rise time observed during subsequent therapy underscores the challenges in maintaining both effective anti-tumor therapy and anticoagulant therapy, necessitating careful management strategies. This case report emphasizes the need for a comprehensive evaluation and tailored therapeutic interventions in similar complex scenarios. In summary, this case report offers valuable clinical insights into the management of intracavitary cardiac metastasis of cervical squamous cell carcinoma, the coexistence of immune thrombocytopenia, and the potential implications of immune checkpoint inhibitors in such cases. Understanding these rare occurrences and their clinical impact can contribute to improved diagnostic approaches, therapeutic decision-making, and patient outcomes.

Dataset Information

Cardiac metastasis from gastric adenocarcinoma: A rare case report.

Introduction and significance

Case presentation

Clinical discussion

Conclusion

Key clinical message

Publications

Cardiac metastasis from gastric adenocarcinoma: A rare case report.

Similar Datasets

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