Metastatic lingual tumors are very rare, and hematogenous myocardial metastasis is also relatively uncommon. We report a case of lung adenosquamous carcinoma with metastases to the tongue and the myocardium. A 65-year-old man underwent a partial upper lobectomy for a primary lung cancer in June 1997. He developed a local recurrence and received two courses of radiotherapy, in March and September 1998. A follow-up computed tomography (CT) scan showed a myocardial tumor, suggestive of cardiac metastasis. In October 1998, he began to complain of anginalike chest oppression and showed ischemic changes on electrocardiogram (ECG), and he also developed lingual, subcutaneous, and brain metastases. He died of respiratory failure in December 1998, 20 months after the initial diagnosis of primary lung cancer; metastases to the tongue and myocardium were confirmed by autopsy.

In 3 patients with traumatic or iatrogenic hemothorax, we conducted transcatheter embolization of the intercostal artery after thoracic drainage. The procedure was completed within 1 hour, and hemostasis was successfully achieved. Few studies have reported intercostal arterial embolization by transcatheter. This procedure is less invasive and requires less time than thoracotomy and thoracoscopic surgery. Even if the volume of hemorrhage is less than the operative indication, this procedure should be conducted aggressively. Complications include spinal infarction related to inflow of embolic materials to the anterior spinal artery and dermal necrosis in the intercostal arterial dominant area. However, these complications can be prevented by carefully confirming the site under direct vision during infusion and carefully selecting embolic materials. Transcatheter arterial embolization may thus be effective for facilitating rapid, safe hemostasis in patients with intercostal arterial injury.