Cardiac Metastasis Presenting As Right Ventricular Outflow Obstruction

Area of Science:

• Cardiology
• Oncology
• Diagnostic Imaging

Background:

• Right ventricular outflow tract obstruction (RVOTO) presents as an elevated systolic pressure gradient between the right ventricle and pulmonary artery.
• RVOTO is a rare condition with diverse etiologies, including cardiac masses, congenital defects, thrombi, and calcification.
• Echocardiography is a key diagnostic tool for identifying RVOTO.

Observation:

• A 73-year-old male experienced syncope and ventricular arrhythmia.
• Imaging revealed a mass compressing the right ventricle, leading to RVOTO.
• The mass was biopsied and identified as squamous cell carcinoma.

Findings:

• The cardiac mass causing RVOTO was confirmed as metastatic squamous cell carcinoma.
• The tumor's likely origin was distant, presumed to be lung cancer.
• This case illustrates an unusual presentation of extrathoracic malignancy.

Implications:

• Metastatic cancer can manifest as a cardiac mass causing significant hemodynamic compromise.
• RVOTO due to a metastatic tumor requires a multidisciplinary approach involving cardiology and oncology.
• This case underscores the need for comprehensive diagnostic workups in patients with unexplained cardiac conditions.