# Diagnostic and Therapeutic Challenges of Cardiac Metastasis in Advanced Malignancies: A Case Series and Literature Review

## TL;DR

This paper discusses two cases of rare heart tumors caused by cancer spread, highlighting the difficulty in diagnosing them and the importance of early detection.

## Contribution

The paper presents two distinct clinical cases of metastatic cardiac tumors and emphasizes the importance of multidisciplinary approaches for accurate diagnosis.

## Key findings

- Cardiac metastases were detected via advanced imaging despite nonspecific symptoms.
- One patient's tumor responded to immunotherapy before surgery, while the other received supportive care.
- The prognosis for cardiac metastasis remains poor despite aggressive treatment.

## Abstract

Background: Cardiac metastases, though more common than primary cardiac tumors, remain under-recognized due to their often subtle clinical presentation. These tumors can lead to life-threatening complications, and their diagnosis is typically delayed.

Objective: This paper is aimed at reviewing two distinct cases of metastatic cardiac tumors, shedding light on diagnostic challenges, clinical presentations, and management approaches.

Methods: We present two cases of patients with metastatic melanoma and undifferentiated malignant spindle cell neoplasm, respectively. Diagnostic imaging, including echocardiography and PET scans, was used to identify the cardiac masses, and biopsy results provided histopathological confirmation. Treatment plans involved systemic immunotherapy, chemotherapy, and surgical resection.

Results: In both cases, cardiac metastases were detected through advanced imaging, despite the patients presenting with nonspecific symptoms like abdominal pain and shortness of breath. The metastatic tumor in one patient responded to immunotherapy before surgical excision, while the other patient, in advanced stages, opted for supportive care.

Conclusion: Cardiac metastasis should be considered in cancer patients who present with unexplained cardiac symptoms. A multidisciplinary approach, including imaging and biopsy, is crucial for accurate diagnosis. Despite aggressive treatment, the prognosis remains poor, emphasizing the need for early detection and better therapeutic strategies.