A Case of Recurrent Vulvar Carcinoma With Cardiac Metastasis: Case Report and Review of the Literature

Abstract

A 67-yr-old female patient was diagnosed with squamous cell vulvar carcinoma and treated with a radical vulvectomy and bilateral sentinel lymphadenectomy. Three months after the surgery, the patient presented with local recurrence and underwent surgical excision of the mass, followed by chemotherapy. Eight months later, the patient was admitted due to weakness and pleural effusion. The patient underwent a chest computed tomography and echocardiogram, which revealed a large mass in the right ventricle penetrating into the pericardium and an additional mass residing on the tricuspid valve. She underwent a pericardial biopsy, and the pathology revealed a moderately differentiated squamous cell carcinoma metastasis. The patient was admitted thereafter in the oncological department for additional chemotherapy treatment. Because of a rapid deterioration in the patient’s condition, only palliative treatment was given, and the patient died shortly after. Secondary cardiac tumors are very rare and have not been extensively studied in oncology. Therefore, optimal management is not entirely clear. It is extremely rare for vulvar cancer to metastasize to the heart, and only a handful of cases have been reported in the literature.

Biventricular cardiac metastasis from vulvar squamous cell carcinoma

“…Of these, four had a tumor located on the right side and two -on the left. [16][17][18][19][20][21]. The peculiarity of our case is that the patient had four myocardial tumors, with pericardial invasion, located in both ventricles, which led to ST segment elevation on the surface ECG, the patient being first interpreted as a patient with STEMI.…”

Malignant Pleural Effusion From Squamous Cell Carcinoma of the Vulva: Extremely Rare Metastatic Pattern of A Rarely Metastasizing Cancer

“…As mentioned, the majority of vulvar carcinoma cases remain localized -with potential invasion of nearby structures -or spread only as far as the regional lymph nodes [6]. The list of metastatic sites reported in the literature includes the central nervous system [10], breast [11], heart [12], lung [13], liver [13], bone [13], skin [13], and muscle [14]. We were able to find only a single published case describing pleural metastases from vulvar carcinoma, also with biopsy-proven squamous histology of pleural implants [15].…”