[Metastatic thyroid cancer to the right ventricle causing obstruction of the right ventricular outflow tract and associated with disseminated intravascular coagulopathy: a case report].
A case of thyroid cancer causing right ventricular outflow tract obstruction is described. A 72-year-old woman was admitted because of shortness of breath, some ecchymoses, and marked anasarca. Her liver was palpable four fingerbreadths below her costal margin. Laboratory findings included leukocytosis, marked thrombocytopenia, and an increase in fibrinogen degradation products due to disseminated intravascular coagulopathy. Two-dimensional echocardiography demonstrated a solid mass in the right ventricle, which protruded into the right atrium and main pulmonary artery. Right ventricular outflow tract obstruction and tricuspid regurgitation were demonstrated by contrast echocardiography. These findings were confirmed by CT scans, RI angiography, and contrast angiography. The mass was partially resected from her right ventricle and her tricuspid valve was replaced successfully, but she died of sepsis three weeks after surgery. At autopsy, undifferentiated thyroid cancer and cardiac metastasis were verified. To date, only eight cases with initial symptoms of congestive heart failure due to right ventricular outflow tract obstruction caused by metastatic intracavitary tumors have been reported. Very rarely have cardiac tumors resulted in disseminated intravascular coagulopathy.
Hara
K
K
Cardiovascular Center, Mitsui Memorial Hospital, Tokyo.
Ohno
M
M
Takenaga
M
M
Tsuneyoshi
H
H
Takeuchi
H
H
Kashida
M
M
Yamaguchi
T
T
Machii
K
K
Furuta
S
S
Tohda
E
E
D000368:Aged; D004211:Disseminated Intravascular Coagulation / Q000209:etiology*; D004452:Echocardiography; D005260:Female; D006331:Heart Diseases / Q000209:etiology*; D006338:Heart Neoplasms / Q000150:complications / Q000473:pathology / Q000556:secondary*; D006352:Heart Ventricles; D006801:Humans; D013964:Thyroid Neoplasms / Q000473:pathology*