Table 1. Cases of intracardiac metastasis of laryngeal cancer.
Abbreviations:
AFib – atrial fibrillation; AV – atrioventricular; CHF – congestive heart failure; CRT – chemoradiation; CT – computed tomography; CXR – chest radiograph; ECG – electrocardiogram; Echo – echocardiogram; F – female, HSM – holosystolic murmur; HR – heart rate; IVS – interventricular septum; L – left; LV – left ventricle; M – male; Mo(s) – month(s); MRI – magnetic resonance imaging; N/A – not available; PET – positron emission tomography; PVC – premature ventricular contraction; R – right; RBBB – right bundle branch block; RT – radiotherapy; RV – right ventricle, RA – left atrium; RLE – right lower extremity; RT – radiotherapy; RWP – R wave progression; SCC – squamous cell carcinoma; SEM – systolic ejection murmur; SOB – shortness of breath; VT – ventricular tachycardia
* short decrescendo diastolic murmur at left sternal border 3rd interspace that increased in intensity with inspiration
**distended jugular veins, hepatomegaly, bilateral pitting oedema
| Author (year), country | Age, gender | Primary site | Stage | Primary treatment | Time from Dx to cardiac mets | Symptom/physical exam findings | Diagnostic test | ECG changes | Cardiac metastasis location | Metastasis treatment |
| Linell (1922), UK [3] | 43 y/o, F | Larynx | IV | Tracheotomy (inoperable tumor) | 12 days | Severe pain over the precordium | Autopsy | N/A | Pericardium, R auricle | None |
| Palmer (1964), USA [11] | 59 y/o, M | R piriform fossa, aryepiglottic fold, R hypopharynx | N/A | Surgery | 1 mo. | Confusion, shock | Autopsy | HR of 180 with bigeminy, tachycardia | Myocardium | None |
| 49 y/o, M | L piriform fossa | N/A | Surgery | 13 mos. | None | Autopsy | N/A | Pericardium, myocardium | None | |
| 58 y/o, M | L piriform fossa | N/A | Surgery | 11 mos. | None | Autopsy | N/A | Myocardium | None | |
| 63 y/o, M | L piriform fossa | N/A | Surgery | 12 days | Tachycardia, intractable CHF | Presumptive by CXR and EKG; autopsy | Nonspecific changes in the T-waves | Myocardium, pericardium | None | |
| Harrer (1970), USA [12] | 69 y/o, M | Larynx | N/A | N/A | 2 mos. (to death) | None | Autopsy | N/A | Intraventricular septum | None |
| 54 y/o, M | Larynx | N/A | N/A | 26 mos. (to death) | None | Autopsy | N/A | Epicardium | None | |
| 32 y/o, M | Larynx | N/A | N/A | 4 mos. (to death) | None | Autopsy | N/A | Pericardium | None | |
| 63 y/o, M | Larynx (anterior commissure, L vocal cord, the base of the epiglottis) | II | RT + surgery (negative surgical margins) | 1 year (15 mos. to death) | Chest pain L anterior side; PVC; grade 3 SEM, grade 2 diastolic murmur* | Autopsy | First degree heart block, RBBB, pathologic Q-waves | Pericardium, epicardium, myocardium of LV, RV, RA, endocardium | None | |
| Barton (1979), UK [13] | 58 y/o, M | Epiglottis, R aryepiglottic fold, arytenoid and false vocal cord | N/A | Surgery + RT | 17 mos. | Chest infection, haemoptysis | Autopsy | N/A | Pericardium, LV, LA, RV | None |
| Tallon (1990), Canada [14] | 50 y/o, F | Hypopharynx, lateral pharyngeal walls, posterior cricoid, larynx | T3N2M0 | Tracheostomy, RT | 8 mos. | SOB, fatigue, anorexia, productive cough | Autopsy | Sinus tachycardia, poor RWP, nonspecific S-T changes in inferior leads | RV endocardium, tricuspid valve | None |
| Larkin (1994), USA [15] | 41 y/o, M | Larynx | IV | Surgery | N/A | Syncope, irregular HR | Echo; autopsy | Rapid AFib; RBBB, persistent ST-elevation in V1 to V6 | Pericardium, RV | None |
| Renders (2005), Belgium [6] | 54 y/o, M | Larynx | T4N2M0 | RT | 4 mos. | SOB, fatigue, atypical chest discomfort; signs of RV failure**, bilateral basal crackles, HSM over tricuspid area | Echo, RV angiogram, CT, MRI, percutaneous RV biopsy | Low QRS voltages, ST segment elevation in leads V2 to V5, 3rd degree AV block | RV | Compassionate care |
| Gullulu (2006), Turkey [1] | 63 y/o, M | Larynx | N/A | CRT + surgery | 1 year | Dull sternal pain, nausea, diaphoresis; coarse crackles in the lower right lung | Postmortem biopsy | New convex ST segment elevation in V1-V4 without Q waves | Myocardium | None |
| Alhakeem (2008), USA [9] | 49 y/o, M | Larynx | N/A | Surgery + RT | 2 years | Dyspnea, left-sided chest pain, hypotension, tachycardia | Echo, CT | Inverted T waves in the infero-lateral leads | RV free wall, LA, LV lateral free wall, IVS, annulus of the tricuspid valve | N/A |
| Kavanagh (2012), Croatia [16] | 50 y/o, M | R hemilarynx, sublingual carcinoma | N/A | RT + surgery (negative surgical margins) | 5 years | Dyspnea; cyanosis; sudden cardiac arrest | Autopsy | Ventricular fibrillation, asystole | RV, conduction system infiltration | None |
| Rangel (2012), Portugal [8] | 71 y/o, M | Larynx | N/A | Surgery + RT | 1 year | Atypical chest pain, worsening fatigue | Echo, CT | Sinus tachycardia, poor RWP, slight ST segment elevation in leads V1-V3 | RV apex and free wall, IVS; pericardium adjacent to LV lateral wall | Palliative treatment proposed |
| Gunduz (2015), Turkey [17] | 47 y/o, M | Larynx | N/A | N/A | N/A | Dyspnea | Echo | N/A | LV endo-myopericardium; RV pericardium | None |
| Vaduganathan (2016), USA [18] | 69 y/o, M | Larynx | N/A | N/A | N/A | Fatigue, stable VT requiring cardioversion | Echo, cardiac MRI | ST elevations in I, aVL, V2-V4, V6; 2:1 AV block | LV mass involving apico-anterolateral and apical septal myocardium | Systemic chemotherapy |
| Tregubenko (2021), USA (current study) | 63 y/o, M | Larynx | T3N2bM0 | Surgery + CRT | 6 mos. | None | PET, echo | Poor RWP, nonspecific ST-T changes in inferior and precordial leads | RV | Palliative RT |