Abstract
Cardiac metastases usually appear in patients with disseminated disease. Solitary metastases to the heart as the initial presentation is very uncommon. This case study reports a patient presenting with ischaemic heart disease and a mobile lesion in the left ventricle. He was scheduled for a coronary artery bypass graft, with intraoperative assessment of the mobile lesion to be performed at the same time. Tissue was sampled for frozen section, which showed a malignant lesion, favouring metastatic carcinoma. The intraoperative cytology showed similar findings. Paraffin sections and immunohistochem-ical studies later confirmed the diagnosis of metastatic squamous cell carcinoma. CT scan showed a left upper lobe pleural-based nodule, a right lower lobe apical segment irregular nodule, and a right subcarinal mass, suggesting a possible lung or oesophageal primary. The patient rapidly deteriorated before any further investigation could be undertaken, and was admitted for palliative care.
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