A metastatic cardiac tumor from colon cancer is an exceedingly rare clinical feature associated with a poor prognosis without therapeutic intervention; however, such cases may be frequently encountered in clinical practice, especially among the elderly. We report a case of synchronous double cancer of the prostate and ascending colon with metastases to multiple organs, including a large cardiac tumor. A 71-year-old Japanese man had prostate cancer with neck and para-aortic metastasis. He visited our hospital with complaints of fatigue and a positive fecal occult blood test result. Colonoscopy findings revealed the presence of a tumor in the ascending colon, and contrast-enhanced CT revealed a tumor in the heart, which was possibly due to metastasis from the ascending colon. The patient received palliative care and declined anticancer treatment. He died due to respiratory failure 3 months after the first diagnosis but did not show critical arrhythmia until death. Autopsy revealed the presence of a large mass in the right ventricle with tumor embolism of the right coronary artery. The cardiac mass was pathologically consistent with metastasis from the colon. In case of colorectal cancer with cardiac metastasis involving poor prognosis or performance status, best supportive care without any therapeutic intervention could be the optimal treatment for the quality of the remaining time.
Case Rep Gastroenterol 2021;15:703–708

中文翻译：

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升序结肠癌的大型转移性心脏肿瘤尸检

结肠癌的转移性心脏肿瘤是一种极为罕见的临床特征，如果没有治疗干预，预后不良；然而，这种情况在临床实践中可能经常遇到，尤其是在老年人中。我们报告了一例前列腺和升结肠同步双癌并转移到多个器官的病例，包括一个大的心脏肿瘤。一名 71 岁的日本男性患有前列腺癌，伴有颈部和主动脉旁转移。他因疲劳和大便潜血试验结果呈阳性来我院就诊。结肠镜检查结果显示升结肠存在肿瘤，增强 CT 显示心脏有肿瘤，这可能是由于升结肠转移所致。患者接受姑息治疗并拒绝抗癌治疗。他在首次诊断后 3 个月因呼吸衰竭死亡，但直到死亡才表现出严重的心律失常。尸检显示右心室存在大肿块伴右冠状动脉肿瘤栓塞。心脏肿块在病理上与结肠转移一致。如果结直肠癌伴有心脏转移的预后或体能状态不佳，最好的支持治疗可能是剩余时间质量的最佳治疗方法。心脏肿块在病理上与结肠转移一致。如果结直肠癌伴有心脏转移的预后或体能状态不佳，最好的支持治疗可能是剩余时间质量的最佳治疗方法。心脏肿块在病理上与结肠转移一致。如果结直肠癌伴有心脏转移的预后或体能状态不佳，最好的支持治疗可能是剩余时间质量的最佳治疗方法。
Case Rep Gastroenterol 2021；15:703–708