Endometroid adenocarcinoma of the uterus with cardiac metastasis. A case report and six-year follow-up.

BACKGROUND

There are few reported cases of cardiac metastasis associated with endometrial cancer (EC) and no reports of long-term survival. We report a case of EC presenting with metastasis to the right ventricle resulting in right heart failure.

METHODS

A 61-year-old woman presented with a 10-day history of increasing pedal edema. Two-dimensional echocardiography (2DE) revealed a large echogenic mass within the right ventricle. She underwent exploration of the heart with debulking which revealed a metastatic poorly differentiated epithelial tumor. Further work-up with a dilation and curettage revealed a poorly differentiated EC. A total abdominal hysterectomy with pelvic and para-aortic lymhadenectomy was performed with disease confined to the uterus/cervix. She then received cardiac radiation with concurrent cisplatin, followed by pegylated liposomal doxorubicin (PLD) for 1 year and remained disease free through 6.5 years of follow-up. At 6.8 years, she died of a constrictive pericarditis with no evidence of disease.

CONCLUSIONS

While experience with cardiac metastasis for gynecologic malignancy is limited, it appears that multimodality therapy affected a durable complete response however late complications of cardiac radiation ultimately lead to death.