Abstract 13127: Cardiac Metastasis of Lingual Squamous Cell Carcinoma, A Systematic Review of Presentation, Management, and Outcomes

Abstract

Introduction: Cardiac metastasis of lingual squamous cell carcinoma (LSCC) describes a rare oncologic progression of oral disease currently ill-defined by medical literature. In this systematic review, we aim to characterize the presentation, management, and outcomes associated with LSCC cardiac metastases. Methods: A comprehensive search of PubMed, Embase, and Cochrane Library databases was performed from inception until December 2019. Inclusion criteria included a histologically diagnosed LSCC, definitive location of cardiac metastasis, and Oxford evidence level of 4. Duplicate, non-English, animal studies, and non-original research were excluded. Patient demographics, presenting symptomology, imaging findings, interventions, and outcomes were collected and analyzed. Results: Twenty-seven articles containing 31 cases met the outlined inclusion criteria. The average age of patient presentation was 55.6 years, ranging from 23-77 years. Average time from primary cancer diagnosis to identification of cardiac metastasis was 2.2 years, varying from 0.2-11.0 years. Shortness of breath (29.0%) and chest pain (29.0%) were the most common presenting symptoms, while effusion (21.2%) and right ventricular outflow obstruction (18.2%) were the predominant echocardiogram findings. Right sided metastases (76.7%) were identified more commonly than left sided metastases (53.3%) and septal metastases (36.7%). Cardiac metastases most commonly presented within the right ventricle (56.7%), followed by the left ventricle (43.3%) (Figure 1). Surgical resection (80.6%) and radiotherapy (74.2%) were the most frequently utilized interventions. No patients obtained remission with treatment and all patients expired within one year of metastatic diagnosis. Conclusions: Cardiac metastases of LSCC demonstrate ventricular predominance and suggest a poor prognosis. Patients may benefit from palliative measures, rather than invasive intervention.