Carcinoid tumors have been described in almost every organ and may affect virtually every body system. Cardiac involvement manifesting as right-sided valvular disease is characteristic of the carcinoid heart disease. Myocardial metastasis is an unusual manifestation of carcinoid heart disease and it was manifested as a mass lesion in the previous reports. We observed a myocardial metastasis of carcinoid tumor manifesting as diffusely infiltrative pattern.
Carcinoid Heart Disease* ; Carcinoid Tumor* ; Neoplasm Metastasis

Carcinoid heart disease is a rare cause of heart failure with or without right valvular heart impairments. In this study, we showed a case of carcinoid tumour with hepatic metastases inducing carcinoid heart disease. Neuroendocrine heart involvement happens for severe tricuspid valve insufficiency and plaques on right ventricular (RV) walls produced by a release of serotonin (5-HT). A patient affected by primitive ileal tumour with 5-HT-secernent hepatic metastases inducing tricuspid insufficiency is showed. Transthoracic 2-D echocardiography showed tricuspid valve regurgitation and both right atrium, RV-walls plaques and RV dilation. Continue-wave Doppler showed a characteristic "dagger shaped" spectrum of tricuspid systolic flow. RV function was evaluated with 3-D transthoracic echocardiography. In particular, RV volumes, RV ejection fraction and stroke volume were defined by this technique. 2, 3-D echocardiography and Doppler method are useful techniques to show heart valves' derangements and RV function to non-invasively detect RV impairments in carcinoid heart disease.
Carcinoid Heart Disease ; Carcinoid Tumor ; Echocardiography ; Echocardiography, Three-Dimensional ; Heart ; Heart Atria ; Heart Failure ; Humans ; Neoplasm Metastasis ; Serotonin ; Stroke Volume ; Tricuspid Valve Insufficiency ; Ventricular Dysfunction, Right

Carcinoid heart disease is characterized by heart valve dysfunction as well as carcinoid symptomatology. We report a case of carcinoid heart disease associated with a primary ovarian tumor. A 60-year-old woman presented for dyspnea evaluation with a history of facial flushing, telangiectatic skin changes, and pitting edema of both lower extremities. Chest radiography showed cardiomegaly, and echocardiography revealed an isolated, severe tricuspid regurgitation without left-sided valvular dysfunction. The tricuspid leaflets were severely retracted and shortened, resulting in poor coaptation. Furthermore, mild pulmonary valve stenosis and moderate regurgitation were found along with this deformation. The 24-hour urine analysis revealed an increased level of 5-hydroxyindoleacetic acid, and an ovarian tumor was apparent on computed tomography images. The mass was surgically removed, and the patient was diagnosed as having a primary ovarian carcinoid tumor. She was treated with chemotherapy and regularly followed-up with supportive treatments, deferring surgical correction.
Carcinoid Heart Disease ; Carcinoid Tumor ; Cardiomegaly ; Dyspnea ; Echocardiography ; Edema ; Female ; Flushing ; Heart Valves ; Humans ; Lower Extremity ; Middle Aged ; Pulmonary Valve Stenosis ; Skin ; Thorax ; Tricuspid Valve Insufficiency

Isolated tricuspid regurgitation (TR) is rare. Generally, TR is caused by pulmonary hypertension secondary to mitral or aortic valve disease, commonly referred to as "functional" regurgitation. The causes of isolated TR in adults include trauma, endocarditis, carcinoid heart disease, and congenital malformation of the tricuspid valve apparatus. In addition, isolated TR should be distinguished from Ebstein anomaly. In the present case, the patient had no definite causes of TR, and neither mitral nor aortic valve disease. The tricuspid valve of this patient showed no abnormalities other than a severely dilated tricuspid annulus. Isolated TR caused by annular dilatation was diagnosed and then ring annuloplasty was perfomed. The subsequent clinical course was satisfactory.
Adult ; Aortic Valve ; Carcinoid Heart Disease ; Dilatation* ; Ebstein Anomaly ; Endocarditis ; Humans ; Hypertension, Pulmonary ; Tricuspid Valve ; Tricuspid Valve Insufficiency*