Basuoni Ahmed, Burney Ikram, Al-Hashami Z, Ahmed Marwa, Kamel Amany Hany Mohamed, de Oliveira Manoel Airton Leonardo, Al Bulushi Yarab, Dawelbeit Waleed
Cardiology Unit, Sultan Qaboos Comprehensive Cancer Care and Research Center, University Medical city, Muscat, Oman.
Women Health Program, Sultan Qaboos Comprehensive Cancer Care and Research Center, University Medical city, Muscat, Oman.
Arch Clin Cases. 2025 Mar 19;12(1):44-50. doi: 10.22551/2025.46.1201.10311. eCollection 2025.
Cardiac metastases are rare but devastating complications of malignancies. Squamous cell carcinoma (SCC), particularly from non-pulmonary origins, infrequently metastasizes to the heart, making its cardiac involvement an unusual and underreported phenomenon. We present a case series of four patients diagnosed with myocardial and endocardial metastases from SCC at our center over two years. Clinical presentation, imaging modalities, suspected metastatic pathways, management strategies, and outcomes were analyzed. Patients (ages 41-74, three males, one female) had primary SCC in the vulva, tongue, buccal mucosa, and lung. Symptoms varied, including dyspnea, hypotension, chest pain, and stroke. All patients had elevated troponin levels. Echocardiography was crucial for initial detection, while PET/CT confirmed metastases, with one patient undergoing cardiac MRI. Hematogenous spread was likely metastatic pathway in most cases. Treatment was primarily palliative; only one patient received chemotherapy post-diagnosis. Survival post-cardiac metastasis diagnosis ranged from a few days to six months. Myocardial and endocardial metastases from SCC are rare and often indicate advanced disease with poor prognosis. Early recognition through multimodal imaging and biomarkers such as troponin may facilitate timely palliative interventions. Increased collaboration between oncology and cardiology may improve supportive care and symptom management in these patients.
心脏转移是恶性肿瘤罕见但极具破坏性的并发症。鳞状细胞癌（SCC），尤其是非肺源性的，很少转移至心脏，使其心脏受累成为一种不常见且报道不足的现象。我们呈现了一个病例系列，包含两年来在我们中心被诊断为SCC心肌和心内膜转移的4例患者。对临床表现、影像学检查方法、疑似转移途径、管理策略及结果进行了分析。患者（年龄41 - 74岁，3例男性，1例女性）的原发性SCC分别位于外阴、舌、颊黏膜和肺。症状各异，包括呼吸困难、低血压、胸痛和中风。所有患者肌钙蛋白水平均升高。超声心动图对初始检测至关重要，而PET/CT证实了转移，其中1例患者接受了心脏MRI检查。大多数情况下血行播散可能是转移途径。治疗主要是姑息性的；仅1例患者在诊断后接受了化疗。心脏转移诊断后的生存期从几天到6个月不等。SCC的心肌和心内膜转移罕见，常提示疾病晚期且预后不良。通过多模态成像和肌钙蛋白等生物标志物进行早期识别，可能有助于及时进行姑息性干预。肿瘤学和心脏病学之间加强合作可能会改善这些患者的支持治疗和症状管理。
