Skip to main content
Top
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Case report

Cardiac metastasis from colon cancer effectively treated with 5-fluorouracil, leucovorin, and oxaliplatin (modified FOLFOX6) plus panitumumab: a case report

Authors: Yoshiki Tsujii, Yoshito Hayashi, Akira Maekawa, Tetsuji Fujinaga, Kengo Nagai, Shunsuke Yoshii, Akihiko Sakatani, Satoshi Hiyama, Shinichiro Shinzaki, Hideki Iijima, Tetsuo Takehara

Published in: BMC Cancer | Issue 1/2017

Login to get access

Abstract

Background

Cardiac metastasis from colorectal cancer is rare. There is little evidence supporting the effectiveness of chemotherapy, and standard therapy for metastatic cardiac tumors has not been established.

Case presentation

A 76-year-old woman presented with a right ventricle tumor that was detected incidentally on screening cardiac ultrasonography. The initial computed tomography (CT) scan showed the cardiac tumor, which was approximately 40 mm in size, and multiple pulmonary nodules. Serum levels of tumor markers CEA and CA19-9 were elevated aberrantly. The suspected primary tumor, a well-differentiated adenocarcinoma of the transverse colon with wild-type KRAS was found by colonoscopy, and treatment with 5-fluorouracil, leucovorin, and oxaliplatin (modified FOLFOX6) plus panitumumab was initiated. After 4 courses of the therapy, a CT scan showed that the cardiac tumor size had markedly decreased and the pulmonary nodules had diminished. The serum levels of CEA and CA19-9 were also markedly decreased. After 12 courses of chemotherapy during 10 months of treatment, the patient continued to show a partial response, and she remained asymptomatic with continuation of the treatment through 15 courses.

Conclusion

To the best of our knowledge, this is the first report of the efficacy of combination therapy using cytotoxic and molecular targeted agents against cardiac metastasis from colon cancer.
Literature
1.
3.
go back to reference Mukai K, Shinkai T, Tominaga K, Shimosato Y. The incidence of secondary tumors of the heart and pericardium: a 10-year study. Jpn J Clin Oncol. 1988;18(3):195–201.PubMed Mukai K, Shinkai T, Tominaga K, Shimosato Y. The incidence of secondary tumors of the heart and pericardium: a 10-year study. Jpn J Clin Oncol. 1988;18(3):195–201.PubMed
4.
go back to reference Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 45-1992. A 75-year-old man with carcinoma of the colon and a right ventricular mass. N Engl J Med. 1992; 327(20):1442-1448. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 45-1992. A 75-year-old man with carcinoma of the colon and a right ventricular mass. N Engl J Med. 1992; 327(20):1442-1448.
5.
go back to reference Choi PW, Kim CN, Chang SH, Chang WI, Kim CY, Choi HM. Cardiac metastasis from colorectal cancer: a case report. World J Gastroenterol. 2009;15(21):2675–8.CrossRefPubMedPubMedCentral Choi PW, Kim CN, Chang SH, Chang WI, Kim CY, Choi HM. Cardiac metastasis from colorectal cancer: a case report. World J Gastroenterol. 2009;15(21):2675–8.CrossRefPubMedPubMedCentral
6.
go back to reference Pizzicannella J, Ricci V, Gorla R, Spinapolice E, Esposito A. Isolated cardiac metastasis from colorectal cancer in a 35-year-old man. Case Rep Med. 2012;2012:751761.PubMedPubMedCentral Pizzicannella J, Ricci V, Gorla R, Spinapolice E, Esposito A. Isolated cardiac metastasis from colorectal cancer in a 35-year-old man. Case Rep Med. 2012;2012:751761.PubMedPubMedCentral
7.
go back to reference Patel SA, Herfel BM, Nolan MA. Metastatic colon cancer involving the right atrium. Tex Heart Inst J. 2012;39(1):79–83.PubMedPubMedCentral Patel SA, Herfel BM, Nolan MA. Metastatic colon cancer involving the right atrium. Tex Heart Inst J. 2012;39(1):79–83.PubMedPubMedCentral
8.
go back to reference Choufani EB, Lazar HL, Hartshorn KL. Two unusual sites of colon cancer metastases and a rare thyroid lymphoma. Case 2. Chemotherapy-responsive right artial metastasis from colon carcinoma. J Clin Oncol. 2001;19(15):3574–5.PubMed Choufani EB, Lazar HL, Hartshorn KL. Two unusual sites of colon cancer metastases and a rare thyroid lymphoma. Case 2. Chemotherapy-responsive right artial metastasis from colon carcinoma. J Clin Oncol. 2001;19(15):3574–5.PubMed
9.
go back to reference Van Cutsem E, Köhne CH, Láng I, Folprecht G, Nowacki MP, Cascinu S, Shchepotin I, Maurel J, Cunningham D, Tejpar S, et al. Cetuximab plus irinotecan, fluorouracil, and leucovorin as first-line treatment for metastatic colorectal cancer: updated analysis of overall survival according to tumor KRAS and BRAF mutation status. J Clin Oncol. 2011;29(15):2011–9.CrossRefPubMed Van Cutsem E, Köhne CH, Láng I, Folprecht G, Nowacki MP, Cascinu S, Shchepotin I, Maurel J, Cunningham D, Tejpar S, et al. Cetuximab plus irinotecan, fluorouracil, and leucovorin as first-line treatment for metastatic colorectal cancer: updated analysis of overall survival according to tumor KRAS and BRAF mutation status. J Clin Oncol. 2011;29(15):2011–9.CrossRefPubMed
10.
go back to reference Douillard JY, Oliner KS, Siena S, Tabernero J, Burkes R, Barugel M, Humblet Y, Bodoky G, Cunningham D, Jassem J, et al. Panitumumab-FOLFOX4 treatment and RAS mutations in colorectal cancer. N Engl J Med. 2013;369(11):1023–34.CrossRefPubMed Douillard JY, Oliner KS, Siena S, Tabernero J, Burkes R, Barugel M, Humblet Y, Bodoky G, Cunningham D, Jassem J, et al. Panitumumab-FOLFOX4 treatment and RAS mutations in colorectal cancer. N Engl J Med. 2013;369(11):1023–34.CrossRefPubMed
11.
go back to reference Ogino H, Nishimura N, Kitamura A, Ishikawa G, Okafuji K, Tomishima Y, Jinta T, Yamazoe M, Yang Y, Chohnabayashi N. A patient with lung squamous cell carcinoma presenting with severe cardiac dysfunction similar to dilated cardiomyopathy with left bundle branch block induced by myocardial metastasis. Intern Med. 2014;53(20):2353–7.CrossRefPubMed Ogino H, Nishimura N, Kitamura A, Ishikawa G, Okafuji K, Tomishima Y, Jinta T, Yamazoe M, Yang Y, Chohnabayashi N. A patient with lung squamous cell carcinoma presenting with severe cardiac dysfunction similar to dilated cardiomyopathy with left bundle branch block induced by myocardial metastasis. Intern Med. 2014;53(20):2353–7.CrossRefPubMed
12.
go back to reference Sladden D, Yamagata K, Pllaha E, Busuttil W. Squamous cell carcinoma of unknown origin metastasising to the right atrium causing acute heart failure. BMJ Case Rep. 2015;2015:210042. Sladden D, Yamagata K, Pllaha E, Busuttil W. Squamous cell carcinoma of unknown origin metastasising to the right atrium causing acute heart failure. BMJ Case Rep. 2015;2015:210042.
13.
go back to reference Motwani M, Kidambi A, Herzog BA, Uddin A, Greenwood JP, Plein S. MR imaging of cardiac tumors and masses: a review of methods and clinical applications. Radiology. 2013;268(1):26–43.CrossRefPubMed Motwani M, Kidambi A, Herzog BA, Uddin A, Greenwood JP, Plein S. MR imaging of cardiac tumors and masses: a review of methods and clinical applications. Radiology. 2013;268(1):26–43.CrossRefPubMed
14.
go back to reference Luna A, Ribes R, Caro P, Vida J, Erasmus JJ. Evaluation of cardiac tumors with magnetic resonance imaging. Eur Radiol. 2005;15(7):1446–55.CrossRefPubMed Luna A, Ribes R, Caro P, Vida J, Erasmus JJ. Evaluation of cardiac tumors with magnetic resonance imaging. Eur Radiol. 2005;15(7):1446–55.CrossRefPubMed
15.
go back to reference Kaminaga T, Takeshita T, Kimura I. Role of magnetic resonance imaging for evaluation of tumors in the cardiac region. Eur Radiol. 2003;13 Suppl 4:L1–L10.CrossRef Kaminaga T, Takeshita T, Kimura I. Role of magnetic resonance imaging for evaluation of tumors in the cardiac region. Eur Radiol. 2003;13 Suppl 4:L1–L10.CrossRef
16.
go back to reference Murphy MC, Sweeney MS, Putnam JB, Walker WE, Frazier OH, Ott DA, Cooley DA. Surgical treatment of cardiac tumors: a 25-year experience. Ann Thorac Surg. 1990;49(4):612–7. discussion 617-618.CrossRefPubMed Murphy MC, Sweeney MS, Putnam JB, Walker WE, Frazier OH, Ott DA, Cooley DA. Surgical treatment of cardiac tumors: a 25-year experience. Ann Thorac Surg. 1990;49(4):612–7. discussion 617-618.CrossRefPubMed
17.
go back to reference Abdalla EK, Vauthey JN, Ellis LM, Ellis V, Pollock R, Broglio KR, Hess K, Curley SA. Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg. 2004;239(6):818–25. discussion 825-817.CrossRefPubMedPubMedCentral Abdalla EK, Vauthey JN, Ellis LM, Ellis V, Pollock R, Broglio KR, Hess K, Curley SA. Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg. 2004;239(6):818–25. discussion 825-817.CrossRefPubMedPubMedCentral
18.
go back to reference Suzuki H, Kiyoshima M, Kitahara M, Asato Y, Amemiya R. Long-term outcomes after surgical resection of pulmonary metastases from colorectal cancer. Ann Thorac Surg. 2015;99(2):435–40.CrossRefPubMed Suzuki H, Kiyoshima M, Kitahara M, Asato Y, Amemiya R. Long-term outcomes after surgical resection of pulmonary metastases from colorectal cancer. Ann Thorac Surg. 2015;99(2):435–40.CrossRefPubMed
19.
go back to reference Douillard JY, Siena S, Peeters M, Koukakis R, Terwey JH, Tabernero J. Impact of early tumour shrinkage and resection on outcomes in patients with wild-type RAS metastatic colorectal cancer. Eur J Cancer. 2015;51(10):1231–42.CrossRefPubMed Douillard JY, Siena S, Peeters M, Koukakis R, Terwey JH, Tabernero J. Impact of early tumour shrinkage and resection on outcomes in patients with wild-type RAS metastatic colorectal cancer. Eur J Cancer. 2015;51(10):1231–42.CrossRefPubMed
20.
go back to reference Schinzari G, Monterisi S, Signorelli D, Cona S, Cassano A, Danza F, Barone C. Cardiac metastasis from renal cell carcinoma successfully treated with pazopanib: impact of TKIs’ antiangiogenic activity. Tumori. 2014;100(6):e298–300.PubMed Schinzari G, Monterisi S, Signorelli D, Cona S, Cassano A, Danza F, Barone C. Cardiac metastasis from renal cell carcinoma successfully treated with pazopanib: impact of TKIs’ antiangiogenic activity. Tumori. 2014;100(6):e298–300.PubMed
21.
go back to reference Szmit S, Zagrodzka M, Kurzyna M, Opolski G, Szczylik C. Sunitinib malate, a receptor tyrosine kinase inhibitor, is effective in the treatment of restrictive heart failure due to heart metastases from renal cell carcinoma. Cardiology. 2009;114(1):67–71.CrossRefPubMed Szmit S, Zagrodzka M, Kurzyna M, Opolski G, Szczylik C. Sunitinib malate, a receptor tyrosine kinase inhibitor, is effective in the treatment of restrictive heart failure due to heart metastases from renal cell carcinoma. Cardiology. 2009;114(1):67–71.CrossRefPubMed
22.
go back to reference Butany J, Nair V, Naseemuddin A, Nair GM, Catton C, Yau T. Cardiac tumours: diagnosis and management. Lancet Oncol. 2005;6(4):219–28.CrossRefPubMed Butany J, Nair V, Naseemuddin A, Nair GM, Catton C, Yau T. Cardiac tumours: diagnosis and management. Lancet Oncol. 2005;6(4):219–28.CrossRefPubMed
23.
go back to reference Hudzik B, Miszalski-Jamka K, Glowacki J, Lekston A, Gierlotka M, Zembala M, Polonski L, Gasior M. Malignant tumors of the heart. Cancer Epidemiol. 2015;39(5):665–72.CrossRefPubMed Hudzik B, Miszalski-Jamka K, Glowacki J, Lekston A, Gierlotka M, Zembala M, Polonski L, Gasior M. Malignant tumors of the heart. Cancer Epidemiol. 2015;39(5):665–72.CrossRefPubMed
Metadata
Title
Cardiac metastasis from colon cancer effectively treated with 5-fluorouracil, leucovorin, and oxaliplatin (modified FOLFOX6) plus panitumumab: a case report
Authors
Yoshiki Tsujii
Yoshito Hayashi
Akira Maekawa
Tetsuji Fujinaga
Kengo Nagai
Shunsuke Yoshii
Akihiko Sakatani
Satoshi Hiyama
Shinichiro Shinzaki
Hideki Iijima
Tetsuo Takehara
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3147-2

Other articles of this Issue 1/2017

BMC Cancer 1/2017 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine