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Cardiac recurrence in a patient with long-term survival from metastatic colon cancer.

Butler A, Wiebke EA - Case Rep Oncol (2012)

Bottom Line: In this brief review, we describe a case of a woman with metastatic disease and long-term survival culminating with an unusual myocardial recurrence.Over three decades, a multimodality approach has evolved to allow for long-term survival in selected patients with metastatic colorectal cancer.In this case report, the role of multiple aggressive surgical resections is emphasized.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, Ind., USA.

ABSTRACT
Metastatic colorectal cancer represents a major health problem in the US and worldwide. Forty percent of patients undergoing resection of the primary tumor will experience relapse. In this brief review, we describe a case of a woman with metastatic disease and long-term survival culminating with an unusual myocardial recurrence. Over three decades, a multimodality approach has evolved to allow for long-term survival in selected patients with metastatic colorectal cancer. In this case report, the role of multiple aggressive surgical resections is emphasized.

No MeSH data available.


Related in: MedlinePlus

PET/CT scan showing recurrence 6 months after pericardial and myocardial resection (white arrows).
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Figure 2: PET/CT scan showing recurrence 6 months after pericardial and myocardial resection (white arrows).

Mentions: In April 2009, the patient underwent reevaluation for elevated CEA. The heart border was abnormal on CT scan, and transesophageal echocardiogram showed a mass in the right atrioventricular groove. MRI confirmed this mass with some tumor involvement in the right atrium. The patient was asymptomatic. Repeat CT and PET scans at this time showed no other evidence of metastatic disease (fig. 1). In May 2009, the patient underwent cardiac surgery (fig. 2) and resection. The resection included right atrium and ventricular free wall with radical pericardectomy. Initial margins were involved, but were negative after additional resection. The defect was repaired with bovine pericardial patch, tricuspid valvuloplasty and bypass grafting. The patient had an uneventful recovery. A follow-up PET/CT scan 6 months after her cardiac surgery showed evidence for extension of the neoplastic disease in her left and right atria, confirmed by MRI. Gene markers confirmed tumor sensitivity to chemotherapy. The patient was started on oxaliplatin-based chemotherapy with bevacizumab. Last visit was November 2011 and she was on single agent bevacizumab without disease progression.


Cardiac recurrence in a patient with long-term survival from metastatic colon cancer.

Butler A, Wiebke EA - Case Rep Oncol (2012)

PET/CT scan showing recurrence 6 months after pericardial and myocardial resection (white arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3362222&req=5

Figure 2: PET/CT scan showing recurrence 6 months after pericardial and myocardial resection (white arrows).
Mentions: In April 2009, the patient underwent reevaluation for elevated CEA. The heart border was abnormal on CT scan, and transesophageal echocardiogram showed a mass in the right atrioventricular groove. MRI confirmed this mass with some tumor involvement in the right atrium. The patient was asymptomatic. Repeat CT and PET scans at this time showed no other evidence of metastatic disease (fig. 1). In May 2009, the patient underwent cardiac surgery (fig. 2) and resection. The resection included right atrium and ventricular free wall with radical pericardectomy. Initial margins were involved, but were negative after additional resection. The defect was repaired with bovine pericardial patch, tricuspid valvuloplasty and bypass grafting. The patient had an uneventful recovery. A follow-up PET/CT scan 6 months after her cardiac surgery showed evidence for extension of the neoplastic disease in her left and right atria, confirmed by MRI. Gene markers confirmed tumor sensitivity to chemotherapy. The patient was started on oxaliplatin-based chemotherapy with bevacizumab. Last visit was November 2011 and she was on single agent bevacizumab without disease progression.

Bottom Line: In this brief review, we describe a case of a woman with metastatic disease and long-term survival culminating with an unusual myocardial recurrence.Over three decades, a multimodality approach has evolved to allow for long-term survival in selected patients with metastatic colorectal cancer.In this case report, the role of multiple aggressive surgical resections is emphasized.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, Ind., USA.

ABSTRACT
Metastatic colorectal cancer represents a major health problem in the US and worldwide. Forty percent of patients undergoing resection of the primary tumor will experience relapse. In this brief review, we describe a case of a woman with metastatic disease and long-term survival culminating with an unusual myocardial recurrence. Over three decades, a multimodality approach has evolved to allow for long-term survival in selected patients with metastatic colorectal cancer. In this case report, the role of multiple aggressive surgical resections is emphasized.

No MeSH data available.


Related in: MedlinePlus