title: Intracaval and intracardiac metastatic nonseminomatous germ cell tumor: a rare cause of hemolytic anemia and thrombocytopenia.
abstract: Intracaval and intracardiac nonseminomatous germ cell tumor metastases although rare have been previously reported in the literature. Most cases arise as a result of direct hematogenous spread via invasion of the internal spermatic vein, or from lymphatic venous shunting. We report a unique case of disseminated testicular germ cell tumor that presented with extensive intracaval and intracardiac metastatic teratoma and with valvular involvement. These findings were heralded by the presence of a new cardiac murmur, anemia, and severe thrombocytopenia. Resection of the intracardiac mass, prompted by rapid tumor progression despite treatment with systemic chemotherapy, demonstrated mature teratoma and resulted in prompt normalization of the patients hematologic profile.
authors.affiliation: Department of Medical Oncology, Montefiore Medical Center, 111 E 210th Street, Hofheimer 1, Albert Einstein College of Medicine, Bronx, NY 10467, USA. adf29@dnamail.com
authors.forename: Ari D
authors.initials: AD
authors.lastname: Fishman
authors.forename: Anthony
authors.initials: A
authors.lastname: Hoffman
authors.forename: Fabio
authors.initials: F
authors.lastname: Volterra
authors.forename: Michael
authors.initials: M
authors.lastname: Frymus
authors.forename: Marco
authors.initials: M
authors.lastname: Gentilluci
mesh_terms: D000293:Adolescent; D000328:Adult; D000743:Anemia, Hemolytic / Q000209:etiology*; D018237:Germinoma / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D006338:Heart Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D006801:Humans; D008297:Male; D009919:Orchiectomy; D013724:Teratoma / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D013736:Testicular Neoplasms / Q000473:pathology* / Q000601:surgery; D013921:Thrombocytopenia / Q000209:etiology*; D014463:Ultrasonography; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery