Key result
A 72-year-old man with tongue squamous cell carcinoma developed an asymptomatic right ventricular myocardial metastasis and died after 4 months despite chemotherapy.
Why the study?
Cardiac metastases of head and neck tumors are extremely rare, with antemortem diagnosis being even rarer, and patients typically present with symptoms or electrocardiographic abnormalities and low expected survival.
Case Report (n=1)
No
This case highlights the importance of multimodality imaging (echocardiography and MRI) in the early antemortem detection of rare, asymptomatic intramyocardial metastases from head and neck tumors.
May warrant cardiac evaluation in advanced tongue cancer; leaves open optimal screening and management strategies.
BACKGROUND Cardiac metastases of head and neck tumors are extremely rare, and antemortem diagnosis is even rarer. In most cases, patients show symptoms or electrocardiographic abnormalities and expected survival is considerably low. CASE REPORT A 72-year-old man was admitted to our cardiology ward with suspected endocarditis 2 months after a right hemiglossectomy for a squamous cell carcinoma. He was asymptomatic and showed no electrocardiogram abnormalities. Echocardiography showed an iso-ipoechogenic round-shaped formation at the right ventricle apex that was suspected to be a metastasis owing to 2 cardiac magnetic resonance imaging examinations showing a significant increase in its volume over 14 days. The patient was evaluated by a multidisciplinary team and referred for first-line chemotherapy with carboplatin, 5-fluoruracil, and cetuximab. He died after almost 4 months of follow-up. CONCLUSIONS This case presents a very rare diagnosis as well as some unique features, including the intramyocardial localization, the absence of symptoms, and electrocardiogram abnormalities. Our report shows the relevance of imaging techniques in defining even the most unusual clinical findings, and it emphasizes the significance of early recognition of cardiac masses in order to identify the appropriate medical or surgical therapy for patients.
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Carbonaro et al. (2021) conducted a case report in Myocardial metastasis of tongue squamous cell carcinoma (n=1). Chemotherapy (carboplatin, 5-fluoruracil, cetuximab) was evaluated on Clinical outcome. A 72-year-old man with tongue squamous cell carcinoma developed an asymptomatic right ventricular myocardial metastasis and died after 4 months despite chemotherapy.
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