Isolated cardiac metastasis from plasmacytoid urothelial carcinoma of the bladder

Experimental Hematology & Oncology

Charles Bush¹  Jennifer Dickerson⁴  Sara Maguire⁵  Charles L Hitchcock²  Joshua R Peck³ 

[1] The Ohio State University Wexner Medical Center, 452 W. 10th Ave, Room H1112, Columbus, 4321, OH, USA;The Ohio State University Wexner Medical Center, Department of Pathology, Columbus, OH, USA;Ohio State University Wexner Medical Center, Department of Internal Medicine/Pediatrics, Columbus, OH, USA;The Ohio State University Richard M. Ross Heart Hospital, Department of Cardiology, Columbus, OH, USA;The Ohio State University College of Medicine, Columbus, OH, USA

关键词: Isolated cardiac metastases;    Urothelial;    Bladder cancer;    PUC;    Plasmacytoid urothelial carcinoma;   

Others  :  814771
DOI  :  10.1186/2162-3619-1-16

 received in 2012-04-17, accepted in 2012-06-24,  发布年份 2012

【 摘 要 】

A 57-year-old male with a history of hypertension presented with shortness of breath, intermittent substernal chest pain, subjective fevers, and a 30-pound weight loss. He was found to have a bladder mass four months prior to presentation, for which he underwent cystoscopy and surgical removal. Pathology demonstrated high-grade superficial plasmacytoid urothelial carcinoma extending into the submucosa but not the muscularis propria. Given the superficial nature of his bladder cancer, a cystectomy was deferred. He was subsequently lost to follow-up care. On arrival, physical exam was notable for tachycardia, tachypnea, and distant heart sounds. An ECG showed an incomplete right bundle branch block and sinus tachycardia. Computed tomography pulmonary angiography revealed a three-cm pericardial effusion. Transthoracic echocardiography confirmed this finding and revealed a mass in the right ventricle (RV) extending into the outflow tract and infiltrating the free wall. The RV was dilated with an estimated RV systolic pressure of 37 mmHg. Pericardiocentesis yielded nearly one liter of serosanguinous fluid with non-diagnostic cytology. Partial median sternotomy with biopsy showed pathologic findings consistent with metastatic urothelial carcinoma, plasmacytoid variant. A PET scan showed increased uptake exclusively in the heart. The oncology team discussed options with the patient including chemotherapy and palliative care. The patient decided to withhold further therapy and went home with hospice care. He died two months later.

【 授权许可】

   
2012 Peck et al.; licensee BioMed Central Ltd.

【 图 表 】

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