Abstract
Metastases to the heart and pericardium are rare but more common than primary cardiac tumours and are generally associated with a rather poor prognosis. Most cases are clinically silent and are undiagnosed in vivo until the autopsy. We present a female patient with a 27-year-old history of an operated primary breast cancer who was presented with dyspnoea, paroxysmal nocturnal dyspnoea and orthopnoea. The clinical signs and symptoms aroused suspicion of congestive heart failure. However, the cardiac metastases were detected during a routine cardiologic evaluation and confirmed with computed tomography imaging. Additionally, this paper outlines the pathophysiology of molecular and clinical mechanisms involved in the metastatic spreading, clinical presentation, diagnostic procedures and treatment of heart metastases. The present case demonstrates that a complete surgical resection and systemic chemotherapy may result in a favourable outcome for many years. However, a lifelong medical follow-up, with the purpose of a detection of metastases, is highly recommended. We strongly call the attention of clinicians to the fact that during the follow-up of all cancer patients, such heart failure may be a harbinger of the secondary heart involvement.
Highlights
Metastases to the heart assume greater diagnostic and therapeutic importance as the incidence of different cancer types rises
We present a case of breast cancer with symptomatic heart metastases and heart chambers involvement 27 years after mastectomy and discuss the pathophysiology of molecular mechanisms of cardiac metastases, metastatic pathways, clinical manifestations, diagnostic procedures and treatment
This manuscript has reviewed some of the key pathways that have been shown to play an important role in the process of breast cancer spreading to the heart and different diagnostic and treatment modalities
Summary
Metastases to the heart assume greater diagnostic and therapeutic importance as the incidence of different cancer types rises. In 1999, a complete clinical re-evaluation was made since the hymoptysis and a solitary metastatic tumour in the distal left lung were diagnosed. In 2005, at regular oncologic follow-up, the patient was diagnosed with a tumour formation under the left scapula which was surgically removed (PHD: Metastatic adenocarcinoma of the breast, ER+, HER-2/neu +++) (Figure 1C and 1D). After that, she was treated with anastrosol and trastuzumab with regular medical follow-up and she felt quite well. The immediate cause of death was cardiorespiratory arrest due to massive involvement of the heart by metastatic malignancy
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
