A 55-year-old man initially presented with an undifferentiated, HPV-p16-negative squamous cell carcinoma (SCC) in the left tonsillar region (cT4a N0 M0), which was treated with a combination of radiotherapy and chemotherapy. Several months later, the patient developed osteoradionecrosis on the left side of the mandible as well as a second primary lesion at the left base of the tongue. Surgical resection and mandibular reconstruction with a free vascularised fibula flap was performed. Regional clinical and radiologic follow-up showed no signs of tumour recurrence. However, routine positron emission tomography (PET)-CT showed a hypermetabolic mass intracardially. MRI confirmed the presence of a mass intramurally in the left ventricle, highly indicative of metastasis. Cardiac metastasis following oral cancer is rare and usually asymptomatic. Therefore, it can be missed easily and is mostly described as a finding postmortem. Reporting these cases is important for contributing to the insight into the uncommon development of metastasis.
- head and neck cancer
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BD and PVC are joint first authors.
BD and PVC contributed equally.
Contributors We, the undersigned, declare that this manuscript is original, has not been published before and is not currently being considered for publication elsewhere. We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us. As the corresponding author, I, BD, declare that PVC contributed equally to this paper and request joint first authorship. We understand that the corresponding author is the sole contact for the editorial process. He is responsible for communicating with the other authors about progress, submissions of revisions and final approval of proofs
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.