Metastatic Tumors O F the Heart

Metastatic tumors of the heart, while of more frequent occurrence than primary lesions, are still of sufficient rarity to warrant the recording of a series of fourteen cases. These cases were found among 327 autopsies performed on cases of known malignancy at the State Institute for the Study of Malignant Disease. Yater, in 1931, published a very comprehensive review of the literature, in which he quotes Karrenstein as to the incidence of cardiac metastases as follows : “In 2,161 autopsies, Chambers found 7 secondary carcinomas of the heart ; from 4,547 autopsies, Willigk reported 9 secondary carcinomas of the heart, 7 of which were in the pericardium; in 4,500 autopsies, Uskoff found 1 secondary carcinoma of the heart; in about 8,500 autopsies, Napp saw 3 secondary carcinomas of the heart; at the Roth Institute of the University of Berlin (Karfenstein) , among 6,655 autopsies there were 15 carcinomas (8 of which mere pericardial) and 4 secondary sarcomas of the pericardium. ” Yater also cites the statistics presented by Peters and Milne. According to these writers, “Rlumensohn reported that in 1,078 caRes of disseminated carcinoma, the heart was involved in 34, and of I60 cases of sarcoma, in 12; Pic and Bret found 25 metastatic carcinomas of the heart in 1,708 autopsies; Phorel found 15 in 3,000 autopsies, and Ely ‘7 in 2,161 autopsies.’’ While our report shows a high percentage of secondary involvement of the heart in proportion to the number of autopsies recorded, a ready explanation is afforded by the fact that the State Institute admits for treatment only cases of neoplastic new growth, most of which are cases of malignancy. Since all our figures are based upon cases of known malignancy, we feel that they offer unusually definite information as to the incidence of metastatic invasion of the heart. This series, offering a fairly wide variation in the type of malignancy and in the location of the primary lesion, is grouped as shown in Table I. I n the majority of these cases general dissemination of the tumor was noted, with multiple metastases to various organs. In no case was the secondary invasion confined to the heart alone. The series consisted of 8 males and 6 females, the youngest being twelve years of age, and the oldest sixty-five. The age distribution is shown in Table 11.