Table 1 Review of documented cases of germ cell tumors with intracardiac involvement
From: Cardiac metastasis from yolk sac tumor: case report and review
Reference (Author/year) | Gender/age (years) | Primary tumor (Histological type) | Time between diagnosis of primary tumor and cardiac metastasis | Cardiac location | Clinical manifestation of cardiac metastasis | Management/Outcome |
|---|---|---|---|---|---|---|
Savarese et al., 1995 [7] | Male/25 | Testicular nonseminomatous mixed germ cell tumor | At diagnosis of the primary tumor | Right atrium extending to right ventricle | Severe low back and epigastric pain, painless swelling of the left, testicle, and a 20-pound weight loss | Surgical resection; 2 years without evidence of recurrence |
Bath et al., 1997 [9] | Female/1.5 | Yolk sac tumor | At diagnosis of the primary tumor | Intrapericardium infiltrating the right atrium | Lethargy, anorexia, tachypnea, cardiomegaly on chest x-ray and pericardial effusion on echocardiogram | Chemotherapy; remission 1 year following completion of treatment |
Vohr et al., 1999 [10] | Male/21 | Testicular nonseminomatous germ cell tumors | At diagnosis of the primary tumor | Right atrium | Syncope | Surgical resection; 1 year after cardiac surgery, a retroperitoneal metastasis was detected; |
Low et al., 1999 [11] | Male/14 | Testicular embryonal carcinoma with extensive vascular emboli | 4 months | Left atrium | Breathlessness for several weeks before hospital admission and dilated veins over the upper thorax | Patient died 6 months after initial diagnosis |
Deck et al., 2000 [12] | Male/20 | Testicular nonseminomatous mixed germ cell tumor | 3 years | Tricuspid valve | A new systolic ejection cardiac murmur | Tricuspid valve replacement; 1 year without evidence of recurrence |
Singh et al., 2000 [13] | Male/27 | Yolk sac tumor | At diagnosis of the primary tumor | Left atrium | Acute lower limb ischemia | Emergency excision of the tumor; patient died 5 weeks after initial presentation |
Alaeddini et al., 2001 [14] | Male/26 | Mixed germ cell testicular tumor (components of yolk sac, embryonal carcinoma, seminoma, and teratoma) | 4 years | Right atrium that prolapsed through the tricuspid valve into the right ventricle | Right-sided heart failure | Surgical resection with tricuspid valve replacement. |
Stefka J., 2003 [15] | Male/40 | Testicular mixed nonseminomatous germ cell tumor (metastatic sarcomatoid germ cell tumor) | 10 years | Right atrium protruding through the tricuspid valve up to the pulmonary valve | Shortness of breath | Surgical resection |
Weinberg et al., 2004 [16] | Male/26 | Testicular seminoma and smaller amounts of choriocarcinoma, teratoma, yolk sac, and embryonal carcinomas | At diagnosis of the primary tumor | Left ventricle | Respiratory distress and stroke | Chemotherapy; patient died 6 months after initial diagnosis |
May et al., 2006 [17] | Male/42 | Testicular germ cell tumor | At diagnosis of the primary tumor | Right atrium extending from the superior vena cava | Left-sided thoracic pain, shortness of breath on exertion, painless swelling of the left testicle, and a 20-pound weight loss | Surgical resection; stable for 12 months after surgery |
Fujimura et al., [18] | Male/30 | Testicular seminoma | 12 years | Pericardium | Shortness of breath | Sudden death |
Liu et al., 2007 [19] | Male/51 | Testicular nonseminomatous germ cell tumor | At diagnosis of the primary tumor | Right atrium extending into the right ventricle and pulmonary arteries bilaterally | Progressive shortness of breath and pleuritic chest pain | Surgical resection; 17 months from initial presentation clinically free of disease. |
Avasthi et al., 2008 [20] | Male/21 | Testicular nonseminomatous mixed germ cell tumor | 2 years | Left atrium | Shock | Died within an hour of admission |
Taghavi et al., 2010 [21] | Male/32 | Testicular nonseminomatous germ cell tumor | At diagnosis of the primary tumor | Right ventricle with an extension into the right atrium | Emergency department very short breath | Chemotherapy; CT-scan at 12-month follow-up revealed complete resolution of the cardiac lesion |
Gursu et al., 2011 [22] | Male/17 | Testicular nonseminomatous germ cell tumor | At diagnosis of the primary tumor | Right atrium | Right-sided heart failure | Surgical excision; stable for 6 months after surgery |
Achouh et al., 2012 [23] | Male/32 | Testicular mixed germ cell tumor | Around 1 year | Right atrium | Thrombosis of superior vena cava and right atrium mass | Not available |
Jonjev et al., 2012 [24] | Male/24 | Testicular mixed germ cell tumor (yolk sac malignant cells with large and pleomorphic nuclei scattered with islands of cartilage) | 2 years | Right atrium | Acute right-sided heart failure | Surgical excision; stable for 6 months after surgery |
Our case/2012 | Female/26 | Mixed germ cell tumor of the right ovary with predominance of endodermal sinus (yolk sac) tumor elements | Metastasis diagnosis before the identification of the primary tumor | Right ventricle | Abdominal pain, weight loss, fever, generalized lymphadenopathy, and acanthosis nigricans | Died before chemotherapy |