Multiple cardiac metastases from a nonfunctioning pancreatic endocrine tumor
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Introduction: Pancreatic endocrine tumors (PETs) are uncommon neoplasm and the most common metastatic site is liver. However, intrathoracic metastasis of PET is very rare. The authors report a case of nonfunctioning PET with multiple cardiac metastases. Case report: A 56-year-old man presented with progressively worsening palpable abdominal mass. Computed tomography (CT) scan of abdomen revealed relatively well marginated inhomogeneous low attenuation masses in the head and tail of pancreas. CT scan of chest and transthoracic echocardiography showed multiple, enhancing masses in left pericardium. A needle biopsy was performed on the masses in the tail of pancreas and left ventricular apical pericardium; histologic examination revealed PET by morphology on H&E and by immunohistochemical staining which was positive for synaptophysin, chromogranin, and CD 56. Conclusion: This is the first report of PET with multiple cardiac metastases of previously undescribed metastatic sites. Although it is very rare, PET has the potential to metastasize to heart or pericardium, and for patients with PETs who present with new cardiac symptoms or signs, the clinician should be alert for the possibility of cardiac metastases.
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