We report a case is whom there was right ventricular outflow tract obstrction by
extended metastasis from esophageal cancer. A 65-year-old man was admitted to
hospital for evaluation of recent onset of weight loss of recent onset and a heart
murmur. Physical examination revealed a regular heart rate of 62 beats per minute and
a blood pressure of 110/70 mmHg. On cardiac auscultation, a grade 4/6 systolic murmur
was heard over the area of pulmonic valve. Electrocardiography showed low voltage.
Chest radiography showed a normal cardiac configuration and no pulmonary abnormality
was seen. Esophagogram and endoscopy showed a 10cm sized ulcerative and infiltrative
esophageal cancer. This esophageal cancer was histologically proven to be a squamous
cell carcinoma. To assess the cardiac metastasis, echocardiography, MRI, coronary
angiography, and endomyocardial biopsy were performed. The MRI, echocardiography
and right ventriculography revealed a 7 cm sized lobulated mass extending to the right
ventricular outflow tract, right ventricle, septum, and anterior wall of the left ventricle.
Interestingly, the feeding vessels of the tumor were identified by echocardiography and
coronary angiography. Histologically, the cardiac tumor was proven to be have the same
pathologic findings as the an esophageal cancer, compatible with carcinomatous
metastasis.
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