Myocardial metastasis from squamous cell carcinoma of the esophagus

A 62-year-old woman was admitted to our hospital because of cancer of the middle thoracic esophagus. We performed a right transthoracic subtotal esophagectomy with systemic three-field lymphadenectomy. Histopathological findings resulted in a diagnosis of well-differentiated squamous cell carcinoma staged as pT3N0M0, pStage IIA, with clear surgical margins. Although she had no clinical symptoms, solitary cardiac metastasis located in the ventricular septum close to the apex was detected on the follow-up computed tomography scans during postoperative month 6. Regardless of chemotherapy followed by radiotherapy, she died of the cancer 17 months after the initial operation. An autopsy revealed metastatic lesions to the heart, lungs, kidneys, and liver. There were two metastatic masses in the heart without direct invasion from the outside of the heart. In cases of esophageal cancer, tumor spread to the heart is usually caused by direct invasion; thus, solitary hematopoietic cardiac metastasis is quite rare.