Solitary right ventricular metastasis of endometrial adenocarcinoma

A woman presented with a solitary cardiac metastasis 5 months after curative surgery for endometrial adenocarcinoma (FIGO IB). The tumor was deemed inoperable and palliative ambulatory chemotherapy was initiated. We aimed at a palliative reduction of tumor mass after chemotherapy and atypical vascularization of the metastasis was demonstrated by coronary angiography. We identified two tumor vessels originating from the ramus circumflexus suitable to palliative percutaneous coronary intervention. Within 5 weeks, the initially mild dyspnea increased to New York Heart Association class III and readmission was planned. Regrettably, our patient died from congestive right heart failure only 2 months after diagnosis of tumor recurrence. This report illustrates the need for resolute action without delay even in cases of only mild right heart failure. <Learning objective: Right ventricular metastasis of gynecologic cancer is a rare phenomenon and prognosis of symptomatic patients is poor. In carefully selected patients with symptomatic disease, a palliative percutaneous intervention is feasible and, if appropriate, should be discussed in an interdisciplinary fashion without delay.>.