Secondary tumors of the heart and pericardium are relatively common in patients with advanced malignancy and can cause fatal cardiac failure, highlighting the need for clinical vigilance using ECG and echocardiography.
Secondary tumors of the heart and pericardium are much more common than primary tumors. During a 10-year period (1976-1985), only one instance of a primary tumor (malignant mesothelioma) was identified among 2,649 autopsies of malignant tumors at the National Cancer Center Hospital. In contrast, there were 407 cases in which heart and/or pericardium were secondarily involved with a malignant tumor from other organs. In 78 cases, the secondary tumors were present only in the pericardium, while in 329 cases, the tumors involved the heart itself with or without pericardial involvement. Among the primary tumors, three-quarters were carcinomas of various organs. In addition there were 53 hematologic malignancies, 19 melanomas and 17 sarcomas. In 31 cases, cardiac failure was the direct cause of death. The secondary tumors of the heart were often overlooked clinically because the cardiac dysfunction appeared to be part of the deteriorating general condition. Electrocardiography and echocardiography were often helpful in suggesting the presence of cardiac metastases. Appropriate diagnostic procedures and therapeutic intervention should be considered for the care of patients with advanced malignancy and sudden onset of cardiac failure.
Mukai et al. (Thu,) studied this question.