Treatment of recurrent isolated right atrial metastatic cavitary mass from breast cancer with radiation therapy: A case report and review of literature

Our plain-English summary of Treatment of recurrent isolated right atrial metastatic cavitary mass from breast cancer with radiation therapy: A case report and review of literature, by L. Ya'qoub, S. Larson, M. Deedy, et al (Echocardiography, 2018).

The study

• Authors: L. Ya'qoub, S. Larson, M. Deedy, I.M. Saeed
• Journal: Echocardiography
• Published: 2018;35(10):1680-1683
• Type of article: Case report, Review
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The heart is a destination for metastases of various types of primary tumors, with lung, breast, melanoma, and mesothelioma being the most common types. Recurrent isolated cardiac metastasis presenting as a cavitary mass is rare. We present a case of recurrent isolated cavitary metastatic mass to the right atrium in a patient with the history of breast cancer who presented with new-onset atrial fibrillation. The patient successfully received radiation therapy with the resolution of the mass confirmed on repeat echocardiography.

© 2018 Wiley Periodicals, Inc.

In plain English

This article is a case report with a short literature review. It does not study asbestos. Mesothelioma appears only in background statements, citing other work, as one of the cancers that commonly spread to the heart. The patient was a 74-year-old woman with a history of breast cancer. Cancer that had spread to her right atrium (an upper chamber of the heart) had been removed surgically in 2012. In 2016 she developed a new irregular heart rhythm, atrial fibrillation. Imaging found a 4.3 by 3 cm mass in the right atrium, with no cancer elsewhere on a PET scan. She was not a candidate for repeat surgery, and her oncologists did not think chemotherapy would help. She received 15 sessions of targeted radiotherapy over 2 months. A heart ultrasound 5 months after treatment showed the mass had resolved, and she had no return of symptoms over 8 months of follow-up. The authors found only two similar cases reported before. They concluded that only a few studies have shown radiation therapy working for cancer that has spread to the heart.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report with review of literature
• Who was studied: One 74-year-old woman with a history of breast ductal adenocarcinoma in both breasts and earlier surgically removed spread to the right atrial wall. She presented in 2016 and was transferred to the authors' institution in Kansas City, Missouri.
• Exposure: No asbestos exposure is described. The article concerns breast cancer that spread to the heart and its treatment with targeted (stereotactic) radiation therapy.
• Main results:
  • Transesophageal echocardiography showed a 4.3 × 3 cm mass in the right atrium extending into the interatrial septum and encroaching on the superior vena cava.
  • Cardiac MRI showed the mass narrowed the superior vena cava to a slit measuring 16 × 5 mm.
  • A PET scan showed increased uptake only in the heart, with no other site of spread.
  • The patient was not a candidate for repeat surgery because of how far the mass extended.
  • She received 15 sessions of targeted stereotactic radiotherapy over 2 months.
  • A repeat transthoracic echocardiogram confirmed the right atrial mass had resolved.
  • She was followed for 8 months after discharge with no return of palpitations or dizziness.
  • The authors' literature review found only two earlier reported cases of breast cancer spreading to the heart as a cavitary mass in the right atrium.
• The authors' conclusion: The authors concluded that cancer spreading to the heart should be considered as a possible cause of heart rhythm problems in patients with a known history of cancer. They also concluded that only a few studies have shown radiation therapy to be effective for cardiac metastasis, and that a multidisciplinary team may be the best approach.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Metastasis.

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