Intramyocardial Metastasis of a Neuroendocrine Neoplasm of the Small Intestine: a Case Report.
Journal Title: Journal of Clinical Cardiology and Cardiac Therapy - Year 2018, Vol 2, Issue 1
Abstract
Neuroendocrine neoplasms of the small intestine are often an incidental finding on imaging studies or diagnosed when already metastasized. Symptoms originate from secreted hormones or mass-effect of the tumor. A 68-year-old man presented with palpitations. He had a history of a metastasized carcinoid and carcinoid syndrome for which he was treated with somatostatin. Upon physical examination he had a normal blood pressure, heartbeat and cardiac auscultation. An electrocardiogram showed no abnormalities. The echocardiography was non-conclusive and a cardiac MRI revealed a nodular thickening in the basal infero-septal wall, indicative for intracardial metastasis. Indeed, a 18F-fluorodihydroxyphenylalanine PET-CT scan showed uptake in the known liver metastasis, but in the myocardium as well. Since the patient did not have arrhythmias or evidence of heart failure, no changes in therapy were made and imaging studies are to be repeated annually. Cardiac metastasis is a rare complication of neuroendocrine neoplasms of the small intestine and should not be confused with carcinoid heart disease. Whenever a patient with a history of a neuroendocrine neoplasm has cardiac complaints, cardiac metastasis should be considered. The therapy of cardiac metastasis is dependent on the location and symptoms. Somatostatin analogue treatment should be considered to halt progression.
Authors and Affiliations
Rieuwerd Bijleveld, R. Uijlings, L. W. Kessels, J. M. B. Manders
Keywords
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- EP ID EP274763
- DOI 10.28967/jccct.2018.01.18001
- Views 147
- Downloads 0
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