Cardiac lymphatic involvement by metastatic tumor

A retrospective study of 2107 consecutive adult autopsies revealed 61 (8.5%) of 716 patients with malignant disease to have cardiac metastases. Ninety-two per cent of the primary tumors (55 of 61) arose within the thoracic cavity or contiguous areas. All but one involved the mediastinal lymph nodes and extended in a retrograde fashion to the cardiac lymphatics. Only 10 cases had any evidence of hematogenous spread, but all had lymphatic involvement also. The data indicate that the cardiac lymphatic system is the most common pathway for tumor reaching the heart. The importance of congestive heart failure secondary to cardiac tumor metastases is stressed and believed to be the immediate cause of death in one third of the cases.