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- Received April 16, 2009
- Revision received May 20, 2009
- Accepted May 26, 2009
- Published online March 16, 2010.
A 62-year old female dialysis patient presented with intermittent fever, dyspnea, and hoarseness (due to a diagnosed thyroid tumor). While she was treated for fever of unknown origin, transthoracic echocardiography (A)showed a solid high-echoic mass (arrow)extending into the main pulmonary artery (PA) and obliterating the right ventricular outflow tract (Online Video 1). The 64-multislice computed tomography scan (B)demonstrated a large ellipsoid mass (59 × 55 × 35 mm) extensively involving the right ventricle (RV) wall. Transvenous biopsy confirmed undifferentiated thyroid carcinoma. At 20 days after admission, the patient died of decompensated heart failure. An autopsy (C)was performed and confirmed the findings of the transthoracic echocardiography, multislice computed tomography, and the biopsy.
Right ventricular outflow tract obstruction from metastatic thyroid cancer is extremely rare (1). We speculate that the patient's immunosuppression therapy as well as being a dialysis patient may have contributed to the tumor's progression.
- Received April 16, 2009.
- Revision received May 20, 2009.
- Accepted May 26, 2009.
- American College of Cardiology Foundation
- McAllister H.A. Jr..,
- Fenoglio J.J.