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Case Reports
. 2017 Oct;9(10):886-888.
doi: 10.14740/jocmr3123w. Epub 2017 Sep 1.

A Rare Case of Atrial Metastasis From a Rectal Adenocarcinoma

Srinivas S Ayyala  1 , Dawnette M Urcuyo  1 , Paul T Kannarkatt  1 , James E Kovacs  2 , Nicole J Terrigno  1
Affiliations
Case Reports

A Rare Case of Atrial Metastasis From a Rectal Adenocarcinoma

Srinivas S Ayyala et al. J Clin Med Res. 2017 Oct.

Abstract

Colorectal cancers typically metastasize to the lymph nodes, liver or lungs. Metastasis to the heart is rare and although a few cases of cardiac metastases from colon cancer are described in the literature, cases of metastatic rectal cancer to the heart are far fewer. A 69-year-old woman with a history of rectal adenocarcinoma treated with neo-adjuvant chemotherapy and radiation, followed by resection and adjuvant chemotherapy, presented with increasing dyspnea on exertion and lower extremity edema 5 years after oncology follow-up. Echocardiography revealed a mass within the right atrium, which was biopsied and found to be consistent with metastatic rectal adenocarcinoma and a thrombus. The patient was deemed to be a poor surgical candidate given her co-morbidities and overall prognosis. Chemotherapy was offered and refused by the patient. The medical literature has a paucity of similar cases of rectal adenocarcinoma metastasizing to the right atrium. Further studies are needed to help guide standardized treatment options.

Keywords: Cardiac metastasis; Cardiac tumors; Colorectal cancer; Rectal adenocarcinoma.

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Figures

Figure 1
Figure 1
A transesophageal echocardiogram in a four-chamber view showing a right atrial mass, 4 × 3.5 cm.
Figure 2
Figure 2
A T2-weighted MRI showing the right atrial, non-mobile and heterogeneously hyperintense mass, measuring 4.6 × 4.2 cm.
Figure 3
Figure 3
Sagittal oblique T2-weighted MRI of the chest showing a heterogeneously hyperintense filling defect in the inferior vena cava from the level of the renal veins into the right atrium. No hepatic mass was present.
Figure 4
Figure 4
Sagittal oblique T2-weighted sequence through the right heart inflow and outflow tracts showing the right atrial mass in the right atrium.
See this image and copyright information in PMC

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