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- W4298007625 abstract "Central MessageCardiac metastases of ATC are rare. Benefits of cardiac surgery on early postoperative survival are very limited. Cardiac metastases of anaplastic thyroid carcinoma (ATC) are extremely rare and mostly documented at the time of autopsy.1Besic N. Gazic B. Sites of metastases of anaplastic thyroid carcinoma: autopsy findings in 45 cases from a single institution.Thyroid. 2013; 23: 709-713Crossref PubMed Scopus (46) Google Scholar Intracavitary lesions should be removed to avoid sudden death and/or pulmonary embolism,2Torbicki A. Galié N. Covezzoli A. Rossi E. De Rosa M. Goldhaber S.Z. ICOPER Study GroupRight heart thrombi in pulmonary embolism: results from the International Cooperative Pulmonary Embolism Registry.J Am Coll Cardiol. 2003; 41: 2245-2251Crossref PubMed Scopus (348) Google Scholar but the poor outcomes associated with ATC yield surgical indications controversial. With his informed consent, we describe the case of a 53-year-old man who underwent thyroidectomy (through left-lateral cervicotomy) and, 2 months later, cardiac surgery to remove an intracardiac metastasis, occupying almost entirely the right heart (Video 1). Thrombosis of the left jugular, subclavian and innominate veins was also demonstrated (Figure 1, A and B). At surgery, left femoral vein and ascending aorta were cannulated to establish extracorporeal circulation. Under cardioplegic arrest, right atriotomy allowed total exeresis of the mass, which appeared completely capsulated (Figure 1, C and D). Histology revealed undifferentiated neoplastic cells within thrombotic organized tissue. Although an early postoperative echocardiogram confirmed cardiac chambers' clearness, the patient underwent resternotomy after 5 days for pericardial (nonthrombotic) effusion and, 15 days later, computed tomography showed the reorganization of the intravascular thrombosis. Despite surgery, his prognosis was deemed ominous, and no other procedures were performed. Noncardiac-related death occurred 2 months later, underlying the very limited value of this intervention, although suggested in other reports,3Catford S.R. Lee K.T. Pace M.D. Marasco S.F. Longano A. Topliss D.J. Cardiac metastasis from thyroid carcinoma.Thyroid. 2011; 21: 855-866Crossref PubMed Scopus (12) Google Scholar on early survival.4Maniakas A. Dadu R. Busaidy N.L. Wang J.R. Ferrarotto R. Lu C. et al.Evaluation of overall survival in patients with anaplastic thyroid carcinoma, 2000-2019.JAMA Oncol. 2020; 6: 1397-1404Crossref PubMed Scopus (72) Google Scholar eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiJhYTkyMWU1ZWQ5NmNlZmJlZjA2ZTQxYzlmODFiOWFhMSIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjcxODMwNDI2fQ.hPghs7Bvm-u6nT5JHaKn5pJichF0rlvreHlfTu9S5cj654muqiM9rDwq45saWxcKYGWEB2cLapKKc76Xtb_oKZoyaaPNx2RN91v25hqDtX0rUiOyrpJxFL9_bgMyvtMFKn6eDwwl0ktcQBOiDSV7Sjq2WDceStjUmjO5vB2wlcquOHITA4HcUrZ4BUIFVCDNvAOip34OFqgOXGQ8xC1aSopgJWyxwF6VeYG5TL9TJuz4h1-cJQihzZfa8ojh6dC3qSvGinHngs-M9NcbQevoS1Xa6YuvbVskleDMpC03rWyHJgIIQSWcmWR6ccBqyau8nowYGkkzaXKxtsqnSrE61g Download .mp4 (0.48 MB) Help with .mp4 files Video 1Preoperative echocardiographic evaluation of the mass occupying almost entirely the right heart. Video available at: https://www.jtcvs.org/article/S2666-2507(22)00513-2/fulltext. Download .jpg (.09 MB) Help with files Video 1Preoperative echocardiographic evaluation of the mass occupying almost entirely the right heart. Video available at: https://www.jtcvs.org/article/S2666-2507(22)00513-2/fulltext." @default.
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- W4298007625 date "2022-12-01" @default.
- W4298007625 modified "2023-10-18" @default.
- W4298007625 title "Giant cardiac lesion in anaplastic thyroid cancer" @default.
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- W4298007625 doi "https://doi.org/10.1016/j.xjtc.2022.08.030" @default.
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