Solitary right ventricular metastasis of endometrial adenocarcinoma

Abstract

A 64-year-old woman presented with swelling of her left leg and mild dyspnea [New York Heart Association (NYHA) class II]. Her medical history consisted of a poorly differentiated adenosquamous carcinoma of the uterus (FIGO 1B, G3). To date, the patient was classified disease-free 5 months after curative surgery (hysterectomy and bilateral salpingo-oophorectomy) with postoperative radiotherapy and denied any B symptoms.Ultrasound revealed old iliacal deep venous thrombosis with only mild elevation of D-dimer (1.2 mg/l). Subsequent computed tomography detected diffuse pulmonary embolism as a probable cause of dyspnea and, surprisingly, a large mass in the right ventricle (RV). Echocardiography showed a nearly complete obstruction of the dilated RV with the beginning of obstruction of the inflow tract, moderate tricuspid regurgitation, developing hepatic congestion, and floating parts of the huge intracardiac mass (Figs. 1 and 2). Echocardiographic measured RV pressure was 30 mmHg, basal RV and areas without direct tumor contact