Isolated Metastatic Myocardial Carcinoid Tumor in a 48-Year-Old Man

Kasi, Vijaykumar S.; Ahsanudin, Arshad N.; Gilbert, C. W.; Orr, Lynn H.; Moran, Jon F.; Sorrell, Vincent L.

doi:10.4065/77.6.591

Cited by 17 publications

(4 citation statements)

References 20 publications

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“…Cardiac metastases rarely display clinical symptoms ( ! 30%) but when present include dyspnea, arrhythmias or accentuation of the carcinoid syndrome [22,24,[34][35][36][37][38] .…”

Section: Clinical Presentationmentioning

confidence: 99%

ENETS Consensus Guidelines for the Management of Brain, Cardiac and Ovarian Metastases from Neuroendocrine Tumors

et al. 2010

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“…Cardiac metastases rarely display clinical symptoms ( ! 30%) but when present include dyspnea, arrhythmias or accentuation of the carcinoid syndrome [22,24,[34][35][36][37][38] .…”

Section: Clinical Presentationmentioning

confidence: 99%

ENETS Consensus Guidelines for the Management of Brain, Cardiac and Ovarian Metastases from Neuroendocrine Tumors

et al. 2010

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“…In 8 of 11 cases of metastatic carcinoid tumor to the heart [ 1 ] there was associated valvular thickening and fibrosis. In addition to this case and the 3 of 11 reported by Pandya [ 1 ], there are other case reports of carcinoid tumor metastatic to the heart, with no carcinoid valvular thickening detected by echocardiography or CMR [ 5 - 8 ]. Metastatic myocardial carcinoid has been identified in the pericardium [ 9 ], but most are intramyocardial [ 1 ] and in one case the intramyocardial metastasis involved the conduction system causing lethal complete heart block [ 10 ].…”

Section: Discussion Of Diagnosismentioning

confidence: 52%

Imaging myocardial carcinoid with T2-STIR CMR

Schiavone

Baker

Prasad

2008

Journal of Cardiovascular Magnetic Resonance

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We used T2-STIR (Short Tau Inversion Recovery) cardiovascular magnetic resonance to demonstrate carcinoid tumor metastases to the heart and liver in a 64-year-old woman with a biopsy-proven ileal carcinoid tumor who was referred because of an abnormal echocardiogram. Case presentationA 64-year-old Middle-Eastern woman was referred to our center for cardiovascular magnetic resonance (CMR) for further evaluation of basal inferior left ventricular (LV) wall thickening that was detected by transthoracic echocardiography done in her home country. The echocardiogram was done to search for cardiac valvular manifestations of a biopsy-proven ileal carcinoid tumor. Multiple CMR imaging sequences were obtained which demonstrated that the basal inferior LV wall thickening was composed of an intramyocardial mass. In addition, there was another smaller (9 mm diameter) intramyocardial mass in the free wall of the right ventricle (RV) and there were multiple masses in the liver. All of these cardiac and hepatic masses had the same magnetic resonance imaging characteristics. Neither the RV mass nor the hepatic masses were reported to be detected by echocardiography. The CMR sequence which best distinguished the metastatic carcinoid cardiac and hepatic tumors from surrounding normal tissue in this case was T2-weighted Short Tau Inversion Recovery (T2-STIR). In addition, CMR demonstrated the absence of carcinoid valvular thickening. In this case, information learned from CMR, guided cardiac surgical and oncologic consultants' clinical decisions. CMR methods and findingsScans were carried out using a Siemens Sonata 1.5 Tesla scanner. Initial localizer images using electrocardiographically-gated Half-Fourier Acquisition Single-shot Turbo spin Echo (HASTE) showed multiple hepatic metastases up to 65 mm × 60 mm in size, and a large intramyocardial mass (43 mm × 35 mm × 32 mm) in the basal inferior wall of the LV. Cine balanced Steady State Free Precession images demonstrated that the intramyocardial mass had fused with the posterior leaflet of the mitral valve, restricting its motion and causing moderate mitral regurgitation. A small amount of pericardial effusion surrounding the mass was noted, but there was no evidence of extension of the mass into the pericardial space.A T2-weighted Short Tau Inversion Recovery (T2-STIR) sequence revealed the LV intramyocardial mass to have a high signal intensity which indicates a high water content that could be caused by active inflammation and/or edema. The same high signal intensity signal was noted in the hepatic masses. A small spherical intramyocardial mass (9 mm in diameter) with the same high signal intensity was identified in the free wall of the right ventricle (RV), which had not been detected by echocardiography nor identified as distinctly by other CMR sequences (Fig.

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“…4 The cases reported have usually demonstrated a discrete mass on echocardiography, rather than the diffuse wall thickening seen in this case. [4][5][6][7] Nearly all cases were associated with the carcinoid syndrome and had hepatic metastases, although one case without hepatic disease has been reported. 5 Carcinoid heart disease with left sided valvular lesions associated with bronchial carcinoids is rare, with an incidence of between 1% and 7%.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] Nearly all cases were associated with the carcinoid syndrome and had hepatic metastases, although one case without hepatic disease has been reported. 5 Carcinoid heart disease with left sided valvular lesions associated with bronchial carcinoids is rare, with an incidence of between 1% and 7%. 8 In this case, there was no evidence of valvular lesions on echocardiography.…”

Section: Discussionmentioning

confidence: 99%

Cardiac metastasis from a bronchial carcinoid: report of a case presenting with diffuse thickening of the left ventricular wall

Goddard

Atkinson²

2004

J Clin Pathol

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Bronchial carcinoids are low grade malignancies with an excellent prognosis and a low incidence of metastases. This report describes a case of a typical carcinoid tumour with metastases to the spine after four years and to the heart after eight years. Carcinoid tumours rarely metastasise to the heart and previous reports have identified gastrointestinal primaries as the source in most cases. This is the first published case of typical carcinoid tumour that metastasised to the heart from a bronchial primary.

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Isolated Metastatic Myocardial Carcinoid Tumor in a 48-Year-Old Man

Cited by 17 publications

References 20 publications

ENETS Consensus Guidelines for the Management of Brain, Cardiac and Ovarian Metastases from Neuroendocrine Tumors

ENETS Consensus Guidelines for the Management of Brain, Cardiac and Ovarian Metastases from Neuroendocrine Tumors

Imaging myocardial carcinoid with T2-STIR CMR

Cardiac metastasis from a bronchial carcinoid: report of a case presenting with diffuse thickening of the left ventricular wall

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