Stereotactic Body Radiation Therapy (SBRT) for a Patient with a Myocardial Metastasis: A Case Report.
Aneesh DharElysia DonovanDarryl LeongSebastien J HotteAnand SwaminathPublished in: Current oncology (Toronto, Ont.) (2021)
Metastatic lesions of the heart are rare but have the potential to cause significant morbidity. We describe the case of a patient with renal cell carcinoma who presented with shortness of breath and palpitations and was found to have a metastatic myocardial lesion causing arrythmia. He received stereotactic body radiation therapy (SBRT) to alleviate symptoms and provide local control. SBRT planning was executed using a four-dimensional computed tomography (4DCT) scan to account for respiratory and cardiac motion. Images from a planning magnetic resonance imaging (MRI) scan and a gated diagnostic MRI scan of the heart were fused with the 4DCT to assist with delineating the tumour. A dose of 30 Gy in five fractions was delivered without incident. The patient's cardiac MRI at two months post-treatment showed stability of his cardiac lesion. He subsequently died of distant disease progression, without any recurrence of his cardiac symptoms. SBRT may be considered for patients who present with a symptomatic metastatic cardiac lesion.
Keyphrases
- radiation therapy
- computed tomography
- magnetic resonance imaging
- left ventricular
- contrast enhanced
- squamous cell carcinoma
- small cell lung cancer
- case report
- renal cell carcinoma
- heart failure
- cardiovascular disease
- type diabetes
- radiation induced
- diffusion weighted imaging
- depressive symptoms
- convolutional neural network
- risk assessment
- magnetic resonance
- human health
- atrial fibrillation
- combination therapy
- pet ct