title: Delayed cardiac metastasis from phyllodes breast tumor presenting as cardiogenic shock.
abstract: Malignant metastases to the heart and pericardium, which occur far more often than do primary cardiac neoplasms, typically lead to fatal outcomes. The phyllodes tumor is a rare, predominantly benign fibroepithelial breast neoplasm with variable malignancy potential. Herein, we describe the case of a 35-year-old woman who, 3 years after undergoing a simple mastectomy for a rapidly enlarging breast neoplasm, presented with cardiogenic shock and was found to have a large right ventricular tumor that obstructed the right ventricular outflow tract. Despite successful resection of the ventricular mass and a right atrial mass of organized thrombus, the patient died 8 days postoperatively of multiorgan failure due to severe right ventricular dysfunction. Histopathologic analysis determined that the right ventricular mass was a malignant, metastatic phyllodes tumor. To our knowledge, this is only the 2nd reported case of a phyllodes tumor that metastasized to the heart and presented as an intracavitary mass with cardiogenic shock. In addition to discussing our patient's case, we review the pertinent medical literature.
authors.affiliation: Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India. navgarg@sgpgi.ac.in
authors.forename: Naveen
authors.initials: N
authors.lastname: Garg
authors.forename: Nagaraja
authors.initials: N
authors.lastname: Moorthy
authors.forename: Surendra K
authors.initials: SK
authors.lastname: Agrawal
authors.forename: Santanu
authors.initials: S
authors.lastname: Pandey
authors.forename: Niraj
authors.initials: N
authors.lastname: Kumari
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D006348:Cardiac Surgical Procedures; D017548:Echocardiography, Transesophageal; D005260:Female; D006338:Heart Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008408:Mastectomy; D003557:Phyllodes Tumor / Q000556:secondary* / Q000601:surgery; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014694:Ventricular Outflow Obstruction / Q000209:etiology