HEART - Secondary carcinoma (metastatic from ovary)

The heart has been opened to display the walls of the left ventricle in which there are three discrete nodules of tumour tissue. The tumour nodules each measure approximately 1cm in diameter. Examination of the pericardial surface at the sides of the specimen shows that this too is infiltrated by tumour, and more tumour nodules within myocardium are seen at the back of the specimen. A further point to note is the anomalous origin of the right coronary artery (it arises higher up in the ascending aorta than usual).
This woman died in 1975. In 1948, a “mucinous cystadenoma” of the left ovary was removed. In 1954 and 1955, metastatic deposits were found in the lungs (they were initially regarded as tuberculous lesions). For various reasons it was not until 1958 that the lung lesions were resected. Histology was the same as the lesion in the ovary. The patient seemed to manage very well, but was ultimately admitted to hospital and died of pneumonia. There is no record of how wide-spread the metastases were, but the length of survival from 1948 to 1975 is worthy of note. The long clinical history suggests that the ovarian tumour might have been a borderline mucinous tumour.