Metastatic squamous cell carcinoma to the heart. Unusual cause of angina decubitus and cardiac murmur

A 61-year-old woman was admitted to the hospital with the new onset of angina at rest and an ECG consistent with anterior wall ischemia. She was also noted to have a new cardiac murmur. Eighteen months earlier, she had been treated for squamous cell carcinoma of the base of the tongue. Thirteen months ago, she had local recurrence treated with radiotherapy, but had no evidence of recurrent or metastatic disease at the time of present admission. Echocardiography revealed intracardiac and extracardiac masses; surgical biopsy confirmed metastatic carcinoma to the heart which was responsible for her symptoms and the new murmur. Symptomatic cardiac metastases from squamous cell carcinoma is an unusual situation which, in this case, was easily diagnosed with echocardiography.