Large Metastatic Cardiac Tumor from Ascending Colon Cancer with Autopsy

A metastatic cardiac tumor from colon cancer is an exceedingly rare clinical feature associated with a poor prognosis without therapeutic intervention; however, such cases may be frequently encountered in clinical practice, especially among the elderly. We report a case of synchronous double cancer of the prostate and ascending colon with metastases to multiple organs, including a large cardiac tumor. A 71-year-old Japanese man had prostate cancer with neck and para-aortic metastasis. He visited our hospital with complaints of fatigue and a positive fecal occult blood test result. Colonoscopy findings revealed the presence of a tumor in the ascending colon, and contrast-enhanced CT revealed a tumor in the heart, which was possibly due to metastasis from the ascending colon. The patient received palliative care and declined anticancer treatment. He died due to respiratory failure 3 months after the first diagnosis but did not show critical arrhythmia until death. Autopsy revealed the presence of a large mass in the right ventricle with tumor embolism of the right coronary artery. The cardiac mass was pathologically consistent with metastasis from the colon. In case of colorectal cancer with cardiac metastasis involving poor prognosis or performance status, best supportive care without any therapeutic intervention could be the optimal treatment for the quality of the remaining time.

Abstract 15104: Malignant Neoplasms of the Heart in the United States

Introduction: Malignant cardiac neoplasms (MCN) are rare and deadly. Metastatic cardiac tumors are known to be more frequent than primary neoplasms of the heart. Due to the uncommon nature of this disease, there are few data-driven studies examining the incidence in the United States or analyzing rates and types of complications. The purpose of our study was to better describe the types, characteristics and trends of MCN in the United States. Methods: This study is a retrospective review of data from the HCUP-NIS Database from 2002-2014. Inclusion criteria consisted of the presence of indication for MCN. Additionally, we queried the database for MCN-associated comorbidities and procedures. SAS studio was utilized for analysis. Results: The data consists of 482,872,274 weighted hospital discharges, 5,610 of which had MCN. Fifty three percent were male. Eighty percent had a metastatic cardiac tumor and twenty percent had a primary neoplasm of the heart (Figure 01). Median cost of admission was 35,855 USD, three times higher than the national average. A total of 568 (10.12%) patients died during the admission. Stroke and arterial embolization were reported in 192 (3.42%) and 54 (0.96%) cases, respectively. Weight loss, fever and endocarditis were reported in 70 (1.24%), 162 (2.89%) and 53 (0.94%) patients, respectively. Pulmonary hypertension co-occurred in 225 (4.01%) patients. Atrial tachyarrhythmias, ventricular arrhythmias, syncope and cardiac arrest were reported in 1,119 (19.95%), 185 (3.30%), 39 (0.70%), and 88 (1.57%) cases. Sinus node dysfunction and severe AV nodal block co-occurred in 46 and 50 patients. Conclusions: Morbidity and mortality are high in patients with MCN. The majority of MCN are associated with metastatic disease, with especially lung, skin/bone/soft tissue and gastrointestinal being the commonest.