Squamous Cell Metastasis from the Tongue to the Myocardium Presenting as Pericardial Effusion

Abstract

Cardiac metastasis from head and neck cancer is rarely encountered. We present a base-of-tongue squamous cell carcinoma with metastasis to the heart that was diagnosed antemortem. Autopsy series indicate that tongue cancer may metastasize more frequently to the heart than from other head and neck sites. However, none of these studies was controlled. Most importantly, cardiac metastasis should be suspected in any patient with cancer in whom new cardiac symptoms develop. The diagnosis is best confirmed with two-dimensional echocardiography or cardiac MRI. A myocardial or endocardial biopsy specimen can be obtained with angiographic guidance. Despite the improvement in diagnostic capability, available treatments are only palliative. All patients eventually die of their metastatic disease.

Squamous Cell Carcinoma of the Tongue with Metastasis to Myocardium: Report of a Case and Literature Review

“…Although no specific ECG findings were reported, ST segment changes were noted in several of the patients (Table 1). Echocardiography was the cornerstone diagnostic modality to show the cardiac mass, and pericardial effusion appeared to be present in many of these patients [7, 8, 10, 11]. Cardiac MRI was used to define the extent of the cardiac mass in a few of the reported cases, as well as in our patient (Table 1).…”

Solitary Myocardial Metastasis from Locoregionally Controlled Squamous Cell Carcinoma of the Oral Cavity

“…Rivkin, et al presented the case of a 57-year-old male with a 1.2 cm lesion in the right ventricle from a right base of tongue primary [ 5 ]. Unfortunately, this patient had extensive disease on subsequent CT scan and was not a resection candidate.…”

Endocardial metastases as the only site of relapse in a patient with bladder carcinoma: A case report and review of the literature

“…In a large series of 7289 autopsy examinations reported recently by Bussani [3] et al the incidence of cardiac metastases diagnosed postmortem was 9.1%, with tumours showing the highest rate being pleural mesothelioma (48.4%), melanoma (27.8%), lung adenocarcinoma (21%), undifferentiated carcinomas (19.5%), lung squamous cell carcinoma (18.2%) and breast carcinoma (15.5%). It should be noted, however, that antemortem clinical diagnosis is far more rare and occasional cases have been reported concerning cardiac metastases from colorectal [4], head and neck [5,6] and thymic carcinoma [7].…”