Right Ventricular Heart Failure from a Cardiac Yolk Sac Tumor

Abstract

Patient: Male, 46Final Diagnosis: Yolk Sac tumorSymptoms: Shortness of breathMedication: —Clinical Procedure: Cardiac MRI • tumor resectionSpecialty: CardiologyObjective:Rare diseaseBackground:Cardiac involvement by a malignant tumor is rare. However, this is a case of right heart failure due to cardiac metastasis from a yolk sac tumor. Although a few case reports of cardiac metastasis from yolk sac tumors have been published, to our knowledge this is the first instance of multiple metastases to the right ventricular of yolk sac tumor in an adult male.Case Report:The patient is a 46-year-old male with a history of testicular cancer that presented with dyspnea on exertion. He was found to have two large right sided intracardiac masses on echocardiography. Cardiac magnetic resonance imaging (MRI) was obtained to further investigate these masses. Right ventricular function was decreased and concern for right ventricular outflow tract (RVOT) obstruction was present. The patient was taken to the operating room (OR) for resection of the cardiac masses. Pathology revealed the masses to be yolk sac tumors. Despite urgent resection of the tumors, the patient deteriorated clinically, ultimately succumbing to heart failure.Conclusions:This unique presentation of a yolk sac tumor emphasizes the need to keep a broad differential and complete a thorough workup for any cardiac mass. Early diagnosis and treatment of intra-cardiac masses is imperative due to their high rates of mortality. Albeit an uncommon etiology for heart failure, germ cell tumors can potentially metastasize to the heart and present with such a clinical picture.

Apresentação Rara de Tumor de Saco Vitelino com Envolvimento Cardíaco: Características Detectadas pela Ressonância Magnética

“…2,3 O TSV de localização intracardíaca é rara, sendo poucos os casos relatados. [4][5][6][7] Relato de caso Uma paciente do sexo feminino, de 1 ano de idade, apresentou-se com episódios de cianose ao chorar. Ao exame físico apresentava frequência cardíaca de 132 bpm, sopro sistólico 2+/6+, desdobramento fixo de segunda bulha cardíaca, perfusão adequada, com pulsos amplos.…”