Cardiac Metastases from Mucosal Head and Neck Squamous Cell Carcinoma

Author(s): Courtney B Shires, Karuna Dewan, Allen Ardestani

Objectives: To understand that cardiac metastasis of mucosal head and neck squamous cell carcinoma (SCCa) is rare and carries a poor prognosis. To acknowledge the possibility of cardiac metastasis in patients with mucosal head and neck SCCa. This condition is usually asymptomatic, but it can present with EKG changes, syncope, or even sudden death. Methods: A single case report of a 55-year-old female with a history of T2N1M0 oral tongue SCCa treated with surgery and postoperative radiation is presented. The patient went on to develop a cardiac septal metastasis. To date, fewer than 35 documented cases of mucosal head and neck SCCa metastasizing to the heart are present within the literature. This is an uncommon but life-threatening condition. Results: In our case, the patient was placed on hospice and passed away in her home 11 months later. A literature review over 35 years (1985-2020) of the incidence, presentation, diagnosis, treatment, and outcome of patients with Head and Neck Mucosal Squamous Cell Carcinoma (HNMSCC) and cardiac metastasis (CM) was performed. CM of HNMSCC occurs on rare occasion, with 33 other documented cases. The most common primary tumor sites were oral tongue (33.3%), and larynx (27.8%). The most common presenting symptoms were dyspnea (16.7%) and chest pain (16.7%). Conclusions: Cardiac metastasis is uncommon but life-threatening long-term sequelae of mucosal head and neck SCCa without any effective treatment options.