External compression by metastatic squamous cell carcinoma: A rare cause of left main coronary artery narrowing

Abstract

Summary: A 69-year-old male with carcinoma of the lung developed unstable angina pectoris during his last few months of life. At necropys, the coronary arteries were free of atherosclerotic plaque, but the left main artery was severely narrowed by external compression from neoplastic metastases. Persistent anterior ST-segment elevation without evolutionary changes of myocardial infarction was a clue to cardiac involvement by tumor. Direct and indirect effects of metastatic tumors upon the coronary arteries include tumor or thrombi, emboli, wall invasion, or extrinsic wall compression. Extrinsic compression of the left main coronary artery is rare among congenital and acquired conditions producing severe left main disease.

Acute myocardial infarction caused by coronary tumor thromboembolism: a rare primary manifestation of malignant tumor disease

“…In patients with lung carcinoma, coronary tumor embolism is theoretically facilitated by the fact that direct embolism from pulmonary veins via the left heart in the coronary arteries is possible. True coronary tumor thromboembolism as the cause of fatal ischemic heart disease, as demonstrated in this case report, in patients with malignant tumors must be differentiated from myocardial infarction because of external compression of large coronary arteries by infiltrative tumor [5]. Another possible cause of myocardial infarction in patients with malignant tumors is a disturbed balance between pro-and anticoagulative processes in the blood, which may eventually lead to conventional coronary thrombosis.…”

Noninfiltrating Adenocarcinoma of the Lung Causing ST-Segment Elevation

“…[5][6][7][8][9] One case report describes a tumor that caused extrinsic compression of an epicardial vessel, which led to myocardial damage. 10 Here, we report an apparently unique case of malignancy that caused STE-by direct apposition of a lung mass on the myocardium without any evidence of cardiac metastases, coronary artery invasion or compression, or pericardial involvement. The persistent current of injury detected on ECG is thought to have occurred from direct myocardial compression.…”

Angina pectoris caused by the extrinsic compression of coronary artery by primary thymic mucinous adenocarcinoma

“…Extrinsic compression of coronary artery by mediastinal mass resulting in significant coronary artery narrowing is very rare, and only a few cases were previously described [3,4]. Weinberg et al [3] described a case of left main coronary artery narrowing caused by the extrinsic compression of lung cancer, and Zeymer et al [4] also reported similar case caused by mediastinal lymphoma.…”

“…Extrinsic compression of coronary artery by mediastinal mass resulting in significant coronary artery narrowing is very rare, and only a few cases were previously described [3,4]. Weinberg et al [3] described a case of left main coronary artery narrowing caused by the extrinsic compression of lung cancer, and Zeymer et al [4] also reported similar case caused by mediastinal lymphoma. Direct invasion and encasement of coronary artery by metastatic tumors was the cause of coronary artery narrowing in these cases, but the simple extrinsic compression of coronary artery by a non-metastatic large mediastinal mass was the cause of significant RCA stenosis in the present case.…”