Table 1 Previous cases of intracardiac metastases of gestational choriocarcinoma
From: Intracardiac metastasis of gestational choriocarcinoma: a case report and literature review
Status of pregnancy | Age | Symptoms | HCG | Cardiac lesion | Lesions at other sites | Surgical treatment | Chemotherapy treatment | Immuno-therapy | Treatment process | Survival | |
|---|---|---|---|---|---|---|---|---|---|---|---|
Akaike A et al | A normal delivery, and a hydatid-form mole | 29 | A rapid onset of malaise and precordial pain | + + + (urinary pregnancy test) | Left anterior descending coronary artery | Both lungs and left kidney | TH + BSO; Segmental resection of lung | Methotrexate + Actinomycin-D; Vinblastin per week; Actinomycin-D + Vinblastin | none | The urinary pregnancy test became negative and the disease is in remission many times | Died suddenly 2 years and 11 months after the onset of symptoms |
Hepp A et al | Two normal delivery | 35 | Chest pain, headache and other multi-system symptoms | unknown | Left atrium, caused a high grade stenosis of the mitral orifice | Spleen, intestinal tract, kidneys, pancreas, brain, and pulmonary lymphatics | none | none | none | Rapid deterioration precluded further diagnosis | Died 6 days after admission to hospital |
Seigle JM et al | An ectopic pregnancy and a normal delivery | 28 | headache, nausea, and vomiting | 108,000 mIU/ml | Left ventricular apex | Spleen, gastrointestinal tract, kidneys, and brain | none | none | none | - | Died 23 days after initial diagnosis |
Vasiljevic JD et al | A normal delivery | 26 | Metrorrhagia, weakness, and signs of fatigue | increased | Any smaller subepicardial coronary vessels and intra-myocardia | no metastases to any organs or systems | none | Methotrexate + Actinomycin-D | none | Complete remission for 6 months, but soon develop symptoms of heart insufficiency | Died with symptoms of chronic heart failure |
Kishore AG et al | Unknown | 27 | Progressive exertional dyspnea, intermittent fever and loss of weight | High | Left atrium, attached to the interatrial septum | Unknown | Atrial mass excision | Methotrexate + Actinomycin-D | none | Almost certain diagnosis of left atrial myxoma | Died on the 12 postoperative day |
Perroni D et al | A normal delivery | 22 | Chest pain and progressive dyspnea | Unknown | Right ventricle and endocardial | none | Cardiac surgery | Methotrexate + Actinomycin-D; EMA-CO*12 | none | Free of disease 4 years and is pregnant again | Remission |
Bohlmann MK et al | Three normal delivery | 41 | Severe dyspnea | 782,000 U/L | Left atrium | none | Hysterectomy; Atrial mass excision | EMA-CO*9 | none | 12 months after cardiac surgery the patient is still in remission | Remission |
Bozaci EA et al | Gravida 12 para 10 abortus 2; History of D&C | 53 | Dyspnea, cough, hemoptysis, and chest pain | 200,000 mIU/mL | Right ventricle | none | TAH + BSO | EMA-CO*4 EMA-EP*4 | none | Remission for 6 months | Remission |
Vincent M et al | Two normal delivery | 27 | Dyspnea, left chest pain, cough and fever | 1032 mIU/mL | Left atrium | Pulmonary and renal | Thrombus excision; Nephrectomy; Pulmonary lesion excision | Cisplatin + etoposide*4 | none | Remain disease-free 16 years and give birth to another child | Remission |
Li Y et al | A normal delivery | 36 | Dizziness, headache, and left-side hemiparesis | 350,000 mIU/mL | Left atrium | Lung and brain | Unknown | Unknown | Unknown | Unknown | Unknown |
Present case | Gravida 4 para 3 abortus 1, | 37 | Vaginal bleeding | 199,060 mIU/mL | Right atrium; Chordae tendinae anterior of tricuspid valve; Right ventricle | Lung | Complete intracardiac masses resection | EMA-CO*5; 5-Fu with KSM*1; FAV*3; TP*1; EMA-EP*1 | none | A right atrial mass was found again 1 week after surgery | Died of disease progression |