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Metastatic Disease
Phillip Young, MD; John P. Lichtenberger, III, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Metastatic tumor deposition or extension of primary tumor into heart
                • Metastases to heart occur via
                  • Lymphatic spread: Most common route; lung and breast cancer
                  • Hematogenous spread: Typically melanoma
                  • Direct extension: Usually lung cancer and thoracic malignancies; rarely mesothelioma
                  • Transvenous spread: several sources
                    • Inferior vena cava (IVC): Hepatic, renal, adrenal or pelvic tumors
                    • Superior vena cava (SVC): Lung cancer; mediastinal tumors
                    • Pulmonary veins: Lung cancer or metastases

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Echocardiographic Findings

                        • Nuclear Medicine Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Young PM et al: Computed tomography imaging of cardiac masses. Radiol Clin North Am. 57(1):75-84, 2019
                                              2. Lichtenberger JP 3rd et al: MR imaging of cardiac masses. Top Magn Reson Imaging. 27(2):103-111, 2018
                                              3. Prakash P et al: Imaging findings of pericardial metastasis on chest computed tomography. J Comput Assist Tomogr. 34(4):554-8, 2010
                                              4. Kalra MK et al: Imaging cardiac tumors. Cancer Treat Res. 143:177-96, 2008
                                              5. Okwuosa TM et al: "Mass-ive" infarction: case report and review of myocardial metastatic malignancies. J Nucl Cardiol. 15(5):719-26, 2008
                                              6. Dodd JD et al: Cardiac septal aneurysm mimicking pseudomass: appearance on ECG-gated cardiac MRI and MDCT. AJR Am J Roentgenol. 188(6):W550-3, 2007
                                              7. Garcia JR et al: Usefulness of 18-fluorodeoxyglucose positron emission tomography in the evaluation of tumor cardiac thrombus from renal cell carcinoma. Clin Transl Oncol. 8(2):124-8, 2006
                                              8. Feys A et al: Cardiac metastasis from a stage IIIb cervix carcinoma. Acta Cardiol. 60(1):73-5, 2005
                                              9. Kim JH et al: Non-small cell lung cancer initially presenting with intracardiac metastasis. Korean J Intern Med. 20(1):86-9, 2005
                                              10. Tesolin M et al: Cardiac metastases from melanoma. Radiographics. 25(1):249-53, 2005
                                              11. Wang ZJ et al: CT and MR imaging of pericardial disease. Radiographics. 23 Spec No:S167-80, 2003
                                              12. Meng Q et al: Echocardiographic and pathological characteristics of cardiac metastasis in patients with lymphoma. Oncol Rep. 9(1):85-8, 2002
                                              13. Chiles C et al: Metastatic involvement of the heart and pericardium: CT and MR imaging. Radiographics. 21(2):439-49, 2001
                                              14. Chahinian AP et al: Tumors of the heart and great vessels. In Bast RC et al: Holland-Frei Cancer Medicine. 5th ed. New York: B.C. Decker, 2000
                                              15. Shimotsu Y et al: Fluorine-18-fluorodeoxyglucose PET identification of cardiac metastasis arising from uterine cervical carcinoma. J Nucl Med. 39(12):2084-7, 1998
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Definitions

                                                            • Metastatic tumor deposition or extension of primary tumor into heart
                                                            • Metastases to heart occur via
                                                              • Lymphatic spread: Most common route; lung and breast cancer
                                                              • Hematogenous spread: Typically melanoma
                                                              • Direct extension: Usually lung cancer and thoracic malignancies; rarely mesothelioma
                                                              • Transvenous spread: several sources
                                                                • Inferior vena cava (IVC): Hepatic, renal, adrenal or pelvic tumors
                                                                • Superior vena cava (SVC): Lung cancer; mediastinal tumors
                                                                • Pulmonary veins: Lung cancer or metastases

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Echocardiographic Findings

                                                                    • Nuclear Medicine Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Gross Pathologic & Surgical Features

                                                                              • Microscopic Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Young PM et al: Computed tomography imaging of cardiac masses. Radiol Clin North Am. 57(1):75-84, 2019
                                                                                          2. Lichtenberger JP 3rd et al: MR imaging of cardiac masses. Top Magn Reson Imaging. 27(2):103-111, 2018
                                                                                          3. Prakash P et al: Imaging findings of pericardial metastasis on chest computed tomography. J Comput Assist Tomogr. 34(4):554-8, 2010
                                                                                          4. Kalra MK et al: Imaging cardiac tumors. Cancer Treat Res. 143:177-96, 2008
                                                                                          5. Okwuosa TM et al: "Mass-ive" infarction: case report and review of myocardial metastatic malignancies. J Nucl Cardiol. 15(5):719-26, 2008
                                                                                          6. Dodd JD et al: Cardiac septal aneurysm mimicking pseudomass: appearance on ECG-gated cardiac MRI and MDCT. AJR Am J Roentgenol. 188(6):W550-3, 2007
                                                                                          7. Garcia JR et al: Usefulness of 18-fluorodeoxyglucose positron emission tomography in the evaluation of tumor cardiac thrombus from renal cell carcinoma. Clin Transl Oncol. 8(2):124-8, 2006
                                                                                          8. Feys A et al: Cardiac metastasis from a stage IIIb cervix carcinoma. Acta Cardiol. 60(1):73-5, 2005
                                                                                          9. Kim JH et al: Non-small cell lung cancer initially presenting with intracardiac metastasis. Korean J Intern Med. 20(1):86-9, 2005
                                                                                          10. Tesolin M et al: Cardiac metastases from melanoma. Radiographics. 25(1):249-53, 2005
                                                                                          11. Wang ZJ et al: CT and MR imaging of pericardial disease. Radiographics. 23 Spec No:S167-80, 2003
                                                                                          12. Meng Q et al: Echocardiographic and pathological characteristics of cardiac metastasis in patients with lymphoma. Oncol Rep. 9(1):85-8, 2002
                                                                                          13. Chiles C et al: Metastatic involvement of the heart and pericardium: CT and MR imaging. Radiographics. 21(2):439-49, 2001
                                                                                          14. Chahinian AP et al: Tumors of the heart and great vessels. In Bast RC et al: Holland-Frei Cancer Medicine. 5th ed. New York: B.C. Decker, 2000
                                                                                          15. Shimotsu Y et al: Fluorine-18-fluorodeoxyglucose PET identification of cardiac metastasis arising from uterine cervical carcinoma. J Nucl Med. 39(12):2084-7, 1998