Cardiac Metastasis from Invasive Thymoma Via the Superior Vena Cava: Cardiac MRI Findings

Abstract

Cardiac tumors are rare, and metastatic deposits are more common than primary cardiac tumors. We present cardiac magnetic resonance imaging (MRI) findings of a 50-year-old woman with invasive thymoma. Cardiac MRI revealed a heterogeneous, lobulated anterior mediastinal mass invading the superior vena cava and extending to the right atrium. In cine images there was no invasion to the right atrial wall.

Intracaval and intracardiac extension of invasive thymoma complicated by superior and inferior vena cava syndrome

“…Intracaval growth of invasive thymoma with extension into the right atrium as shown in the present case is extremely rare, and to our knowledge, only 27 cases have been reported in the English literature or in Japanese literature with English abstract (Table ). As shown in Table , this manifestation of thymoma may occur in any age of adults (25–80 y.o.…”

“…Thymoma is one of the most common tumors in the mediastinum and accounts for 45% of anterior mediastinal tumors in adults, mainly affecting people aged 40–60 years . Thymomas are classified as invasive or noninvasive, depending on the presence or absence of tumor capsular invasion and/or anatomic extension . Invasive thymomas, accounting for approximately 30% of thymomas, may invade mediastinal organs such as pleura and pericardium, but they rarely invade the superior vena cava (SVC) .…”

Thymoma Inducing Superior Vena Caval Syndrome

“…Invasive thymoma commonly invades surrounding thoracic structures such as the heart, lungs, and vessels causing compressive symptoms [4]. SVC obstruction sets in usually because of external compression and uncommonly from transcaval thymoma encroachment [5].…”

Right-sided invasive metastatic thymoma of the heart

“…Haematogenous and lymphatogenous spread from intrathoracic tumours (lung cancer, breast carcinoma, and mesothelioma) or haematological malignancies (leukaemia and lymphoma) are most frequent, while direct extension has been described primarily from thymoma and oesophageal cancer [1]. Whereas most thymomas with cardiac involvement are limited to the pericardium [2], cases of extension in the caval vein and right atrium have also been described [3, 4]. We describe a case of a highly malignant thymoma with involvement of different cardiac structures with important haemodynamic compromise.…”