Echocardiography and PET imaging identified a rare cardiac metastasis involving the left ventricle and mitral annulus in a 38-year-old male with squamous cell carcinoma of the tongue.
Case Report (n=1)
Highlights a rare case of cardiac metastasis from squamous cell carcinoma of the tongue diagnosed via multimodality imaging.
Case: A 38-year-old male presented with ulcero-nodular lesion in left buccal mucosa extending into the tongue. Biopsy revealed moderately differentiated squamous cell carcinoma. Screening echocardiogram revealed mass at the junction of basal left ventricle and mitral annulus with infiltration into the base of the posterior mitral leaflet as visualised in apical-four-chamber view (Figure 1A, arrow, Video 1) and parasternal-long-axis view (Figure 1B, arrow, Video 2). This mass was found to be approximately 1 × 3 cm in size, isoechoic, homogenous, freely mobile without a well-defined stalk and with irregular borders. Associated mild mitral regurgitation was also noted. There was no pericardial effusion. X-ray chest (Figure 1C) showed cannon ball secondaries in lungs. Whole body positron emission tomography (PET) scan (Video 3), done as part of metastasis work up, revealed increased fluorodeoxy-glucose (FDG) uptake in the left buccal mucosa extending into the tongue. Increased FDG uptake was also noted in the left ventricle wall towards the basal side infiltrating the base of the posterior mitral leaflet, suggestive of cardiac metastatic deposit (Figure 1D, arrow). In addition, PET scan also showed metastasis involving lungs, mediastinal and cervical lymph nodes, and 8 th rib bilaterally. Squamous cell carcinoma of tongue with cardiac metastasis is a rare occurrence 1,2. Patient expired after 2 months of diagnosis.
Mufti et al. (Fri,) conducted a case report in Squamous cell carcinoma of tongue with cardiac metastasis (n=1). Echocardiography and Positron Emission Tomography (PET) was evaluated. Echocardiography and PET imaging identified a rare cardiac metastasis involving the left ventricle and mitral annulus in a 38-year-old male with squamous cell carcinoma of the tongue.