Metastatic and invasive tumours involving the heart in a geriatric population: a necropsy study.

In a series of 744 necropsied subjects with a diffuse malignant process, 57 cases of cardiac involvement were observed (50 metastatic carcinomas and 7 lymphomas or myeloproliferative disorders). The most frequent site of involvement was the pericardium and epicardium in lung or breast carcinoma, suggesting regional lymphatic invasion. Myocardial involvement was rarer and usually associated with cutaneous melanoma and lymphoma, suggesting haematogenic invasion. Endocardial involvement was exceptional. The multiple causes of heart disturbance in the elderly cloud the clinical diagnosis of such cardiac involvement; however, isolated pericardial and/or epicardial abnormalities should heighten suspicion of a neoplastic process.