Metastatic lesions of the heart are rare but have the potential to cause significant morbidity. We describe the case of a patient with renal cell carcinoma who presented with shortness of breath and palpitations and was found to have a metastatic myocardial lesion causing arrythmia. He received stereotactic body radiation therapy (SBRT) to alleviate symptoms and provide local control. SBRT planning was executed using a four-dimensional computed tomography (4DCT) scan to account for respiratory and cardiac motion. Images from a planning magnetic resonance imaging (MRI) scan and a gated diagnostic MRI scan of the heart were fused with the 4DCT to assist with delineating the tumour. A dose of 30 Gy in five fractions was delivered without incident. The patient's cardiac MRI at two months post-treatment showed stability of his cardiac lesion. He subsequently died of distant disease progression, without any recurrence of his cardiac symptoms. SBRT may be considered for patients who present with a symptomatic metastatic cardiac lesion.

中文翻译：

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心肌转移患者的立体定向放射治疗 (SBRT)：病例报告

心脏的转移性病变很少见，但有可能导致严重的发病率。我们描述了一个肾细胞癌患者的案例，该患者表现为呼吸急促和心悸，并被发现有导致心律失常的转移性心肌病变。他接受了立体定向放射治疗 (SBRT) 以缓解症状并提供局部控制。SBRT 计划是使用四维计算机断层扫描 (4DCT) 扫描来执行的，以考虑呼吸和心脏运动。来自计划磁共振成像 (MRI) 扫描和心脏门控诊断 MRI 扫描的图像与 4DCT 融合，以帮助描绘肿瘤。30 Gy 的剂量分五次给药，没有发生意外。患者在治疗后两个月的心脏 MRI 显示其心脏病变稳定。他随后死于远处疾病进展，没有任何心脏症状复发。对于出现有症状的转移性心脏病变的患者，可以考虑 SBRT。