Malignant Neoplasms Arising in the Cardiac Pacemaker Cavity: A Systematic Review

SIMPLE SUMMARY: Cancer, a complex group of diseases marked by abnormal cell proliferation and loss of physiological functions. Furthermore, tumors in the cardiac pacemaker pocket are rare and challenging medical problems, where the location of the implanted devices employed to manage heart rhythm disorders unexpectedly becomes a site for neoplasm growth. This intersection becomes even more nuanced with the rise in cardiac pacemaker (PM) implantations, a common practice globally. This study aimed to evaluate reported cases of this condition throughout the existing literature, in addition to enhancing early detection strategies and improving the management of affected patients. ABSTRACT: Cancer is the abnormal proliferation of physiologically inadequate cells. Studies have identified the cardiac pacemaker pocket as a site of rare neoplasms. To evaluate the clinical outcomes, treatment, prognosis, and individualized management of tumors originating in the cardiac pacemaker pocket, a systematic review was conducted using case reports and case series available in the PubMed/Medline, Science Direct, Cochrane Central, LILACS, and Scientific Electronic Library Online (Scielo) databases. Pacemaker pocket tumors affected patients with a mean age of 72.9 years, with a higher incidence in males (76.9%, n = 10). The average time for neoplasm development was 4.4 years (54.07 months). The most prevalent model was Medtronic (38.4%, n = 5), with titanium (83.3%) being the most common metal composition. Chemotherapy was the most performed procedure among patients (38.4%), followed by radiation therapy (38.4%) and surgical tumor resection (30.7%). Six analyzed cases (46.1%) resulted in death, and four patients (30.7%) achieved a cure. Patients with pacemakers should be routinely evaluated for the occurrence of malignant tumors at the site of device implantation.