A Rare Case of Right Ventricular Cardiac Metastasis from Urothelial Carcinoma Presenting with Multifocal Stroke and Massive Pulmonary Embolism
K.Mouammine *
Department of Cardiology, CHU Ibn Rochd, Casablanca, Morocco.
J.Yamoul Jihane
Department of Cardiology, CHU Ibn Rochd, Casablanca, Morocco.
R.Habbal
Department of Cardiology, CHU Ibn Rochd, Casablanca, Morocco.
S Arous
Department of Cardiology, CHU Ibn Rochd, Casablanca, Morocco.
M.Bennouna
Department of Cardiology, CHU Ibn Rochd, Casablanca, Morocco.
A.Drighil
Department of Cardiology, CHU Ibn Rochd, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: Cardiac metastases from urothelial carcinoma are rare and often clinically silent. Right ventricular (RV) involvement is exceptionally uncommon and may present with embolic complications.
Case Summary: We report the case of a 68-year-old male with metastatic urothelial carcinoma, admitted with right hemibody weakness. Brain MRI revealed multifocal ischemic infarcts. Echocardiography showed a mobile mass in the right ventricle, attached to the interventricular septum, suggestive of metastasis. CT angiography revealed bilateral massive pulmonary embolism. Despite curative anticoagulation and intensive care, the patient died within 48 hours.
Conclusion: This case illustrates the diagnostic challenge and poor prognosis associated with RV cardiac metastases. In cancer patients presenting with embolic events, intracardiac tumor masses should be considered.
Keywords: Cardiac metastasis, right ventricle, urothelial carcinoma, pulmonary embolism, cardioembolic stroke