Metastasizing testicular germ-cell tumor with infiltration of the right heart: indication for primary metastasectomy

Abstract

Cardiac intracavitary metastases are very uncommon. The case of a 42-year-old male patient with a testicular germ cell tumor extending into the superior caval vein, the left brachiocephalic vein, and the right heart, which manifested as a mild form of pulmonary embolization, is presented. Due to the perceived high risk of continuous embolization and the urgent need to begin systemic chemotherapy, a complete cardiac tumor resection was performed, utilizing a cardiopulmonary bypass, followed by a simultaneous orchiectomy. Histology revealed a 61-cm long vascular tumor as a metastasis of a yolk sac tumor originating from the left testis. There were no postoperative complications, and the patient is alive and without tumor recurrence 12 months after four cycles of systemic chemotherapy according to the PEB (cisplatin, etoposide, bleomycin) scheme. We conclude that in this special case aggressive surgical management following chemotherapy was very effective in controlling the disseminated testicular tumor.

Metastatic Testicular Cancer to Left Atrium via the Left Inferior Pulmonary Vein: A Case Report

“…It also guided anesthetic management based on the real-time continuous monitoring of physiology. In light of the recent success of cisplatin-based chemotherapeutic agents, prognosis is favorable when tumor burden including thrombi are removed [ 3 ] ( Figure 2 ).…”

Trombocitopenia severa como manifestación de un tumor testicular de células germinales con metástasis cardíaca intracavitaria

“…1 Dentro de las principales potenciales complicaciones de una masa tumoral de las cavidades derechas se encuentra el riesgo de embolia pulmonar, hipertensión pulmonar aguda y muerte. 7 En relación al tratamiento de los tumores testiculares depende del estadío en que se encuentren al momento del diagnóstico. En términos generales el diagnóstico histológico se establece mediante la orquidectomía correspondiente y la etapificación se completa con estudio de …”

Surgical experience with right ventricular tumors in 17 patients

“…Concomitant surgery of the tricuspid valve after resection of an RV tumor may include tricuspid annuloplasty by Kay's method, 8 the De Vega method, 9,10,14,16,[21][22][23] the Cosgrove band, 13,18 the Carpentier Edwards ring, 12 chordoplasty, 21 valvuloplasty, 6,21 or tricuspid valve replacement. 19,[24][25][26] Most patients who undergo tricuspid repair have endocardial tumors 8,10,[13][14][15][16][17][18]23 ; few have epicardial tumors.…”

“…19,[24][25][26] Most patients who undergo tricuspid repair have endocardial tumors 8,10,[13][14][15][16][17][18]23 ; few have epicardial tumors. 9 The endocardial tumors reported were 40-610 mm in maximum diameter in adults (n = 6; median 80 mm), 10,[3][4][5][6][7][8][9][10][11][12][13][14][15]17,23 with the exception of cases with tumor adherent to the tricuspid valve leafl et (25-30 mm diameter) 16,18 or tumors arising from the papillary muscle of the tricuspid valve without tricuspid valve involvement (12 mm diameter). 8 It is thought that the existence of a tumor of such size in the RV cavity induces dilatation of the cavity and subsequently of the tricuspid annulus suffi cient to cause tricuspid regurgitation.…”