Left ventricular metastasis from tongue squamous cell carcinoma presenting with ventricular tachycardia: a case...

Cardiac metastasis from tongue squamous cell carcinoma (TSCC) is extremely rare. Endocardial involvement, particularly in the left heart, occurs in only 3%-6% of cases and is often asymptomatic until advanced stages. Early detection is challenging but critical to prevent life-threatening complications.

A 75-year-old man with a history of TSCC presented with non-sustained ventricular tachycardia (NSVT) detected during routine post-operative surveillance. Transthoracic and transoesophageal echocardiography, cardiac magnetic resonance imaging, and contrast-enhanced computed tomography revealed a well-defined mass in the left ventricular cavity infiltrating the anterolateral papillary muscle. Surgical excision with concomitant mitral valve replacement was performed. Histopathology confirmed metastatic TSCC. Post-operatively, ventricular arrhythmias resolved completely, and the patient remained recurrence-free with preserved cardiac function during follow-up.

This case highlights the rare presentation of left-sided endocardial cardiac metastasis from TSCC manifesting as potentially life-threatening ventricular arrhythmias. It emphasizes the importance of considering cardiac metastasis in cancer patients with new-onset arrhythmias, demonstrates the diagnostic utility of multi-modal imaging, and underscores the therapeutic benefit of timely surgical intervention in selected patients.