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Cardiac metastasis from gallbladder carcinoma.

Gunjiganvi M, Singh KK, Harsha HS, Bipin T - Int J Surg Case Rep (2013)

Bottom Line: Metastasis to heart presents with symptoms of cardiac failure due to pericardial effusion.Metastatic spread to heart from carcinoma of gallbladder is very rare.Should a patient be suspected of or an operated case of gallbladder carcinoma present with symptoms of congestive heart failure and massive pericardial effusion, cardiac metastasis should be considered.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Regional Institute of Medical Sciences, Imphal, India. Electronic address: msgunjigaon@gmail.com.

No MeSH data available.


Related in: MedlinePlus

Chest X-ray showing cardiomegaly.
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fig0005: Chest X-ray showing cardiomegaly.

Mentions: At admission, chest X-ray (Fig. 1) showed cardiomegaly with diffuse mild interstitial thickening in bilateral lung fields. Electrocardiogram showed sinus rhythm with low voltage complexes. 2-D echocardiography (ECHO) showed moderate pericardial effusion (13 mm). USG whole abdomen was done to look for tumour recurrence. USG (abdomen) showed post cholecystectomy status with bilateral pleural effusion and moderate pericardial effusion. Serum carcino-embryonic antigen (1.0 ng/mL) and alpha-fetoprotein (2.5 IU/mL) were within normal limits. Patient was started on conservative treatment for the pericardial effusion. However, patient's condition worsened with increase in severity of dyspnoea and orthopnoea. Repeat 2-D ECHO (Figs. 2 and 3) showed massive pericardial effusion, metastatic tumour deposits on the surface of myocardium and left sided pleural effusion. Initially repeated transcutaneous pericardiocentesis was done. However, analysis of this haemorrhagic pericardial fluid for malignant cells was negative. Patient was subjected for mini-thoracotomy, and pericardial window procedure was done under general anaesthesia due to worsening symptoms. Massive pericardial effusion was drained and biopsy of pericardial tissue was sent for histopathological study. The report revealed metastatic adenocarcinoma: “fibro-adipose collagenous tissue with focal areas of benign mesothelial lining, stroma infiltrated by malignant tumour composed of cells arranged in infiltrating singles, cords, clusters and occasional well-formed glandular pattern, individual cells have moderate amount of cytoplasm and highly pleomorphic vesicular nuclei, intervening stroma shows moderate lympho-plasmocytic cell infiltration” (Figs. 4 and 5). Even with palliative procedure, patient succumbed to the disease in the post-operative period due to progressive dyspnoea and acute respiratory distress syndrome.


Cardiac metastasis from gallbladder carcinoma.

Gunjiganvi M, Singh KK, Harsha HS, Bipin T - Int J Surg Case Rep (2013)

Chest X-ray showing cardiomegaly.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3860051&req=5

fig0005: Chest X-ray showing cardiomegaly.
Mentions: At admission, chest X-ray (Fig. 1) showed cardiomegaly with diffuse mild interstitial thickening in bilateral lung fields. Electrocardiogram showed sinus rhythm with low voltage complexes. 2-D echocardiography (ECHO) showed moderate pericardial effusion (13 mm). USG whole abdomen was done to look for tumour recurrence. USG (abdomen) showed post cholecystectomy status with bilateral pleural effusion and moderate pericardial effusion. Serum carcino-embryonic antigen (1.0 ng/mL) and alpha-fetoprotein (2.5 IU/mL) were within normal limits. Patient was started on conservative treatment for the pericardial effusion. However, patient's condition worsened with increase in severity of dyspnoea and orthopnoea. Repeat 2-D ECHO (Figs. 2 and 3) showed massive pericardial effusion, metastatic tumour deposits on the surface of myocardium and left sided pleural effusion. Initially repeated transcutaneous pericardiocentesis was done. However, analysis of this haemorrhagic pericardial fluid for malignant cells was negative. Patient was subjected for mini-thoracotomy, and pericardial window procedure was done under general anaesthesia due to worsening symptoms. Massive pericardial effusion was drained and biopsy of pericardial tissue was sent for histopathological study. The report revealed metastatic adenocarcinoma: “fibro-adipose collagenous tissue with focal areas of benign mesothelial lining, stroma infiltrated by malignant tumour composed of cells arranged in infiltrating singles, cords, clusters and occasional well-formed glandular pattern, individual cells have moderate amount of cytoplasm and highly pleomorphic vesicular nuclei, intervening stroma shows moderate lympho-plasmocytic cell infiltration” (Figs. 4 and 5). Even with palliative procedure, patient succumbed to the disease in the post-operative period due to progressive dyspnoea and acute respiratory distress syndrome.

Bottom Line: Metastasis to heart presents with symptoms of cardiac failure due to pericardial effusion.Metastatic spread to heart from carcinoma of gallbladder is very rare.Should a patient be suspected of or an operated case of gallbladder carcinoma present with symptoms of congestive heart failure and massive pericardial effusion, cardiac metastasis should be considered.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Regional Institute of Medical Sciences, Imphal, India. Electronic address: msgunjigaon@gmail.com.

No MeSH data available.


Related in: MedlinePlus