Skip to main content

Main menu

  • Home
  • Content
    • Current Issue
    • Ahead of Print
    • Past Issues
    • Supplements
    • Article Type
  • Specialty
    • Articles by Specialty
  • CME/MOC
    • Articles
    • Calendar
  • Info For
    • Manuscript Submission
    • Authors & Reviewers
    • Subscriptions
    • About CCJM
    • Contact Us
    • Media Kit
  • Conversations with Leaders
  • Conference Coverage
    • Kidney Week 2024
    • CHEST 2024
    • ACR Convergence 2023
    • Kidney Week 2023
    • ObesityWeek 2023
    • IDWeek 2023
    • CHEST 2023
    • MDS 2023
    • IAS 2023
    • ACP 2023
    • AAN 2023
    • ACC / WCC 2023
    • AAAAI Meeting 2023
    • ACR Convergence 2022
    • Kidney Week 2022
    • AIDS 2022
  • Other Publications
    • www.clevelandclinic.org

User menu

  • Register
  • Log in

Search

  • Advanced search
Cleveland Clinic Journal of Medicine
  • Other Publications
    • www.clevelandclinic.org
  • Register
  • Log in
Cleveland Clinic Journal of Medicine

Advanced Search

  • Home
  • Content
    • Current Issue
    • Ahead of Print
    • Past Issues
    • Supplements
    • Article Type
  • Specialty
    • Articles by Specialty
  • CME/MOC
    • Articles
    • Calendar
  • Info For
    • Manuscript Submission
    • Authors & Reviewers
    • Subscriptions
    • About CCJM
    • Contact Us
    • Media Kit
  • Conversations with Leaders
  • Conference Coverage
    • Kidney Week 2024
    • CHEST 2024
    • ACR Convergence 2023
    • Kidney Week 2023
    • ObesityWeek 2023
    • IDWeek 2023
    • CHEST 2023
    • MDS 2023
    • IAS 2023
    • ACP 2023
    • AAN 2023
    • ACC / WCC 2023
    • AAAAI Meeting 2023
    • ACR Convergence 2022
    • Kidney Week 2022
    • AIDS 2022
Departments

Cardiac mass: Tumor or thrombus? (July 2017)

Mahmoud Abdelghany, MD, Moustafa Elsheshtawy, MD and Hani Kozman, MD
Cleveland Clinic Journal of Medicine September 2017, 84 (9) 659; DOI: https://doi.org/10.3949/ccjm.84c.09003
Mahmoud Abdelghany
Department of Medicine, Division of Cardiology, State University of New York, Upstate Medical University, Syracuse, NY
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Moustafa Elsheshtawy
Department of Medicine, Division of Cardiology, Maimonides Medical Center, Brooklyn, NY
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Hani Kozman
Department of Medicine, Division of Cardiology, State University of New York, Upstate Medical University, Syracuse, NY
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • PDF
Loading

TO THE EDITOR: We read with great interest the article by Patnaik et al1 about a patient who had a cardiac metastasis of ovarian cancer, and we would like to raise a few points.

It is important to clarify that metastatic cardiac tumors are not necessary malignant. Intravenous leiomyomatosis is a benign small-muscle tumor that can spread to the heart, causing various cardiac symptoms.2 Even with extensive disease, patients with intravenous leiomyomatosis may remain asymptomatic until cardiac involvement occurs. The most common cardiac symptoms are dyspnea, syncope, and lower-extremity edema.

Cardiac involvement in intravenous leiomyomatosis may occur via direct invasion or hematogenous or lymphatic spread of the tumor. In leiomyoma and leiomyosarcoma, cardiac invasion usually occurs via direct spread through the inferior vena cava into the right atrium and ventricle. Thus, cardiac involvement with these tumors (except for nephroma) was reported to exclusively involve the right side of the heart.

In 2014, we reported a unique case of intravenous leiomyomatosis that extended from the right side into the left side of the heart and the aorta via an atrial septal defect.2 Intracardiac extension of intravenous leiomyomatosis may result in pulmonary embolism, systemic embolization if involving the leftside, and, rarely, sudden death.2

In patients with malignancy, differentiating between thrombosis and tumor is critical These patients have a hypercoagulable state and a fourfold increase in thrombosis risk, and chemotherapy increases this risk even more.3 Although tissue pathology examination is important for differentiating thrombo sis from tumor, visualization of the direct extension of the mass from the primary source into the heart through the inferior vena cava by ultrasonography, computed tomography, or magnetic resonance imaging may help in making this distinction.2

  • Copyright © 2017 The Cleveland Clinic Foundation. All Rights Reserved.

REFERENCES

  1. ↵
    1. Patnaik S,
    2. Shah M,
    3. Sharma S,
    4. Ram P,
    5. Rammohan HS,
    6. Rubin A
    . A large mass in the right ventricle: tumor or thrombus? Cleve Clin J Med 2017; 84:517–519.
    OpenUrlFREE Full Text
  2. ↵
    1. Abdelghany M,
    2. Sodagam A,
    3. Patel P,
    4. Goldblatt C,
    5. Patel R
    . Intracardiac atypical leiomyoma involving all four cardiac chambers and the aorta. Rev Cardiovasc Med 2014; 15:271–275.
    OpenUrl
  3. ↵
    1. Khorana AA,
    2. Kuderer NM,
    3. Culakova E,
    4. Lyman GH,
    5. Francis CW
    . Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood 2008;111:4902–4907.
    OpenUrlAbstract/FREE Full Text
PreviousNext
Back to top

In this issue

Cleveland Clinic Journal of Medicine: 84 (9)
Cleveland Clinic Journal of Medicine
Vol. 84, Issue 9
1 Sep 2017
  • Table of Contents
  • Table of Contents (PDF)
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Cleveland Clinic Journal of Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Cardiac mass: Tumor or thrombus? (July 2017)
(Your Name) has sent you a message from Cleveland Clinic Journal of Medicine
(Your Name) thought you would like to see the Cleveland Clinic Journal of Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Cardiac mass: Tumor or thrombus? (July 2017)
Mahmoud Abdelghany, Moustafa Elsheshtawy, Hani Kozman
Cleveland Clinic Journal of Medicine Sep 2017, 84 (9) 659; DOI: 10.3949/ccjm.84c.09003

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Cardiac mass: Tumor or thrombus? (July 2017)
Mahmoud Abdelghany, Moustafa Elsheshtawy, Hani Kozman
Cleveland Clinic Journal of Medicine Sep 2017, 84 (9) 659; DOI: 10.3949/ccjm.84c.09003
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Linkedin Share Button

Jump to section

  • Article
    • REFERENCES
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

Departments

  • When should we consider SGLT-2 inhibitors in patients with acute decompensated heart failure?
  • Our Peer-Reviewers for 2023
  • Our Peer-Reviewers For 2022
Show more Departments

Letters to the editor

  • In Reply: In defense of the anion gap
  • In defense of the anion gap
  • In Reply: Insomnia in older adults
Show more Letters to the editor

Similar Articles

Subjects

  • Cardiology
  • Imaging
  • Oncology

Navigate

  • Current Issue
  • Past Issues
  • Supplements
  • Article Type
  • Specialty
  • CME/MOC Articles
  • CME/MOC Calendar
  • Media Kit

Authors & Reviewers

  • Manuscript Submission
  • Authors & Reviewers
  • Subscriptions
  • About CCJM
  • Contact Us
  • Cleveland Clinic Center for Continuing Education
  • Consult QD

Share your suggestions!

Copyright © 2025 The Cleveland Clinic Foundation. All rights reserved. The information provided is for educational purposes only. Use of this website is subject to the website terms of use and privacy policy. 

Powered by HighWire