Ventricular tachycardia due to infiltration of interatrial septum with gastric lymphoma

Abstract

Metastatic cardiac involvement occurs most often during the terminal stage of the malignant disease, associated with wide spread of the tumor, and it is generally diagnosed at autopsy. A 39-year old woman was taken to coronary intensive care unit with the diagnosis of ventricular tachycardia while she had been following in the medical oncology clinic for gastric lymphoma. Ventricular tachycardia was in polymorphic character. On the other hand, her first electrocardiogram in the oncology clinic was normal sinus rhythm. To rule out ischemia, coronary computed tomography (CT) angiography was done. All the coronary arteries were intact without any plaque formation. But thickening in the interatrial septum and superomedial and lateral walls of right atrium and increase in the soft tissue density were reported. The magnetic resonance imaging (MRI) reported a soft tissue lesion with 28x37x25 mm in size. The hyperintense lesion showed uptake of heterogenous contrast and expanded to both atrial cavities. The MRI report commented that it was reasonable to evaluate this view as the involvement of intertribal septum with metastasis of lymphoma especially when it was beared in mind that she had been under treatment of this disease. The appearance of a cardiac arrhythmia in the absence of known cardiac disease should raise the possibility of a cardiac metastasis in patients with malignant disease. So in patients with malign process, cardiac metastasis of the disease should be considered especially when patients present with cardiovascular symptoms. J. Exp. Clin. Med., 2013; 30:79-80