Intracardiac metastasis from head and neck squamous cell carcinoma

• Published in: BMJ case reports Vol. 13; no. 6; p. e234691
• Main Authors: Abu Khalaf, Suha, Riaz, Talha, Mansour, Abdallah, Doll, Donald
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 30-06-2020; BMJ Publishing Group
• Series: Case report
• Subjects: Adrenal glands; Biopsy; Breast cancer; Bronchoscopy; Case reports; Chemoradiotherapy, Adjuvant - methods; Diagnosis, Differential; Embolic Stroke - diagnosis; Embolic Stroke - etiology; Embolic Stroke - physiopathology; Endocarditis; Fatal Outcome; Gallbladder; Head & neck cancer; Heart attacks; Heart Neoplasms - pathology; Heart Neoplasms - physiopathology; Heart Neoplasms - secondary; Heart Neoplasms - surgery; Humans; Immune Checkpoint Inhibitors - administration & dosage; Ischemia; Lymphatic system; Male; Medical imaging; Metastasis; Middle Aged; Neck Dissection - methods; Neoplasm Grading; Neoplasm Staging; Nivolumab - administration & dosage; Palatine Tonsil - diagnostic imaging; Palatine Tonsil - pathology; Palatine Tonsil - surgery; Positron Emission Tomography Computed Tomography - methods; Radiation therapy; Sinuses; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck - pathology; Squamous Cell Carcinoma of Head and Neck - physiopathology; Squamous Cell Carcinoma of Head and Neck - surgery; Stroke; Tomography; Tonsillectomy - methods; Tumors; Ultrasonic imaging; Unusual Presentation of More Common Disease/Injury; Veins & arteries; head and neck cancer; stroke; cancer - see oncology
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2020-234691

Cardiac metastasis from head and neck cancer is an extremely rare and devastating condition with an abysmal prognosis. Most of our knowledge about this condition is from case reports and series. We present a case of squamous cell carcinoma of the tonsils that was complicated by embolic stroke and critical limb ischemia that were found to be secondary to intracardiac metastasis. We believe that this condition is under-reported; hence, we conducted a thorough review of the literature to highlight the characteristics and previous therapeutic experiences with various presentations of cardiac metastasis from head and neck carcinoma. Clinicians are encouraged to report their experience with evaluating and managing this type of metastasis.