Abstract
Background: Cardiac metastasis is usually seen with lung carcinomas or malignant melanoma, but rarely with leukemia, and is usually a post-mortem diagnosis. Secondary cardiac tumors arising from the left atrium, where benign myxomas predominate, are uncommon. Case presentation: We report a 22-year old Filipino male, recently diagnosed with acute T-cell lymphoblastic leukemia, presenting with right-sided heart failure symptoms. On work-up, transthoracic echocardiogram showed a mass with mixed echogenicity, irregular borders and broad-base attachment to the anterior and posterior walls of the left atrium. He was treated with nitrates, ivabradine, captopril and digoxin; and subsequently underwent chemotherapy with vincristine, doxurubicin, intrathecal methotrexate and cytarabine. Right-sided heart failure symptoms improved after initiation of chemotherapy. Resolution of the left atrial tumor was documented after completion of induction chemotherapy. Conclusion: Cardiac metastasis should be considered in patients with acute lymphoblastic leukemia presenting with right-sided heart failure. Chemotherapy and supportive cardiac medications should be considered in these cases. Other treatment options should also be investigated.
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