Metastatic Cardiac Papillary Carcinoma Originating From the Thyroid in Both Ventricles With a Mobile Right Ventricular Pedunculated Tumor

概要

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A 62-year-old man with a history of surgical therapy for papillary thyroid carcinoma was admitted because of chest pain, dyspnca on effort, pretibial edcma, and slight fever. An electrocardiogram showed ST segment elevation in the precordial leads and low voltage in the limb leads. A large solid mass was demonstrated in both ventricles, with pericardial effusion, by echocardiography, thoracic computed tomography scan, transesophageal echocardiography, and angiography. A punch biopsy of the tumor revealed metastasic papillary carcinoma. During radiation therapy, the patient suddenly died of ventricular fibrillation. At autopsy, the tumor occupied almost the entire right ventricular cavity, expanding toward the main trunk of the pulmonary artery with a mobile peduncle and it had infiltrated the left ventricular wall through the interventricular septum. Microscopic examination confirmed metastatic papillary thyroid carcinoma. Only 2 other cases of cardiac metastases of papillary thyroid carcinoma have been reported and this case is the first report of metastases in both ventricles with a mobile right ventricular pedunculated tumor.
社団法人日本循環器学会の論文
2000-10-20