PDF(Pubmed)
Abstract：
BACKGROUND: Metastatic cardiac tumors are known to occur more frequently than primary cardiac tumors, however, they often remain asymptomatic and are commonly discovered on autopsy. Malignant tumors with a relatively high frequency of cardiac metastasis include mesothelioma, melanoma, lung cancer, and breast cancer, whereas reports of esophageal cancer with cardiac metastasis are rare.
METHODS: The case of a 60-year-old man who complained of dysphagia is presented. Upper gastrointestinal endoscopy showed a submucosal tumor-like elevated lesion in the esophagus causing stenosis. Contrast-enhanced computed tomography showed left atrial compression due to the esophageal tumor, multiple liver and lung metastases, and a left pleural effusion. Pathological examination of a biopsy specimen from the esophageal tumor showed spindle-shaped cells, raising suspicion of esophageal sarcoma. The disease progressed rapidly, and systemic chemotherapy was deemed necessary, however, due to his poor general condition, administration of cytotoxic agents was considered difficult. Given his high Combined Positive Score, nivolumab was administered, however, the patient soon died from the disease. The autopsy confirmed spindle cell carcinoma (SCC) of the esophagus and cardiac metastasis with similar histological features. Cancer stem cell markers, ZEB1 and TWIST, were positive in both the primary tumor and the cardiac metastasis.
CONCLUSIONS: To the best of our knowledge, there have been no prior reports of cardiac metastasis of esophageal SCC. This case highlights our experience with a patient with esophageal SCC who progressed rapidly and died from the disease, with the autopsy examination showing cardiac metastasis.
METHODS: The case of a 60-year-old man who complained of dysphagia is presented. Upper gastrointestinal endoscopy showed a submucosal tumor-like elevated lesion in the esophagus causing stenosis. Contrast-enhanced computed tomography showed left atrial compression due to the esophageal tumor, multiple liver and lung metastases, and a left pleural effusion. Pathological examination of a biopsy specimen from the esophageal tumor showed spindle-shaped cells, raising suspicion of esophageal sarcoma. The disease progressed rapidly, and systemic chemotherapy was deemed necessary, however, due to his poor general condition, administration of cytotoxic agents was considered difficult. Given his high Combined Positive Score, nivolumab was administered, however, the patient soon died from the disease. The autopsy confirmed spindle cell carcinoma (SCC) of the esophagus and cardiac metastasis with similar histological features. Cancer stem cell markers, ZEB1 and TWIST, were positive in both the primary tumor and the cardiac metastasis.
CONCLUSIONS: To the best of our knowledge, there have been no prior reports of cardiac metastasis of esophageal SCC. This case highlights our experience with a patient with esophageal SCC who progressed rapidly and died from the disease, with the autopsy examination showing cardiac metastasis.
摘要：
背景：已知转移性心脏肿瘤比原发性心脏肿瘤发生更频繁，然而,它们通常无症状，通常在尸检中发现。心脏转移频率相对较高的恶性肿瘤包括间皮瘤，黑色素瘤，肺癌,和乳腺癌，而食管癌伴心脏转移的报道很少。
方法：介绍了一名60岁男性主诉吞咽困难的病例。上消化道内窥镜检查显示食管粘膜下肿瘤样升高的病变，导致狭窄。对比增强计算机断层扫描显示食管肿瘤导致左心房受压，多发性肝和肺转移，还有左侧胸腔积液.食管肿瘤活检标本的病理检查显示梭形细胞，怀疑是食道肉瘤.疾病进展迅速，全身化疗被认为是必要的，然而,由于他的一般情况不好，细胞毒性剂的给药被认为是困难的。鉴于他的综合积极得分很高，nivolumab给药，然而,病人很快就死于这种疾病。尸检证实食管梭形细胞癌（SCC）和心脏转移具有相似的组织学特征。癌症干细胞标志物,ZEB1和TWIST,在原发肿瘤和心脏转移中均为阳性。
结论：据我们所知，以前没有关于食管SCC心脏转移的报道.这个病例突出了我们对一位进展迅速并死于该病的食道SCC患者的经验，尸检显示心脏转移.
方法：介绍了一名60岁男性主诉吞咽困难的病例。上消化道内窥镜检查显示食管粘膜下肿瘤样升高的病变，导致狭窄。对比增强计算机断层扫描显示食管肿瘤导致左心房受压，多发性肝和肺转移，还有左侧胸腔积液.食管肿瘤活检标本的病理检查显示梭形细胞，怀疑是食道肉瘤.疾病进展迅速，全身化疗被认为是必要的，然而,由于他的一般情况不好，细胞毒性剂的给药被认为是困难的。鉴于他的综合积极得分很高，nivolumab给药，然而,病人很快就死于这种疾病。尸检证实食管梭形细胞癌（SCC）和心脏转移具有相似的组织学特征。癌症干细胞标志物,ZEB1和TWIST,在原发肿瘤和心脏转移中均为阳性。
结论：据我们所知，以前没有关于食管SCC心脏转移的报道.这个病例突出了我们对一位进展迅速并死于该病的食道SCC患者的经验，尸检显示心脏转移.
