Concomitant Pulmonary and Cerebral Tumor Embolism and Intracardiac Metastasis from Bladder Cancer

Intern Med. 2021 Dec 1;60(23):3749-3753. doi: 10.2169/internalmedicine.6765-20. Epub 2021 Jun 12.

Abstract

An 82-year-old woman with a history of bladder cancer presented with dyspnea and loss of consciousness. Contrast-enhanced computed tomography revealed pulmonary embolism, and emergency thrombus aspiration therapy was performed, but the thrombus was not aspirated. Echocardiography showed mobile masses in the heart and a right-to-left shunt due to a patent foramen ovale (PFO). Magnetic resonance imaging showed multiple cerebral infarctions. Surgical thrombectomy and PFO closure were performed, and the patient was diagnosed with intracardiac metastasis of bladder cancer based on intraoperative histopathology. This is a rare case of concomitant pulmonary and cerebral tumor embolism and intracardiac metastasis from bladder cancer.

Keywords: intracardiac metastasis; paradoxical embolism; patent foramen ovale; pulmonary artery aspiration cytology; pulmonary tumor embolism.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Embolism, Paradoxical*
  • Female
  • Foramen Ovale, Patent*
  • Humans
  • Neoplastic Cells, Circulating*
  • Pulmonary Embolism* / diagnosis
  • Pulmonary Embolism* / etiology
  • Urinary Bladder Neoplasms* / complications
  • Urinary Bladder Neoplasms* / diagnosis
  • Urinary Bladder Neoplasms* / surgery