Cardiac Metastasis in a Patient With a Bronchial Carcinoid

Carcinoid tumors are a subgroup of neuroendocrine tumors that secrete serotonin (5-hydroxytryptamine). These tumors are relatively uncommon, with an annual incidence of 2.47 to 4.48 per 100 000 persons in the general population. The percentage of bronchial carcinoids is 25.3%. Metastasis may occur at any time, from long before until 30 years after the initial diagnosis; in 12.9% of patients, metastases were already evident at the time of diagnosis.1 We report on the case of a patient diagnosed with a single myocardial metastasis related to a bronchial carcinoid tumor that was resected 33 years previously.A 56-year–old man was referred to the cardiology clinic with an 8-year history of self-limited episodes of palpitations, accompanied by epigastric discomfort and sweating. The patient reported no dyspnea, chest pain, syncope, or secretory diarrhea. Thirty-three years earlier he had undergone a lobectomy of the middle and right lower lobes related to an intrabronchial carcinoid tumor that never received follow-up tests or treatment. Physical examination showed no anomalies. The ECG showed sinus rhythm with anterolateral low-voltage negative T waves. Laboratory tests of blood and urine, including 5-hydroxyindoleacetic acid, yielded normal values. Holter monitoring was performed, which showed only low-density …