Case Report: Complete heart block as a manifestation of cardiac metastasis of oral cancer [version 2; peer review: 2 approved]

Metastatic tumors of the heart presenting with complete heart block (CHB) is an extremely uncommon case. There are no available guidelines in managing CHB in terminal cancer. Permanent pacemaker implantation in such cases is a challenge in terms of clinical utility and palliative care. We report a c...

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Bibliographic Details
Published in:F1000 research 2020, Vol.9, p.1243
Main Authors: Andrianto, Andrianto, Mulia, Eka Prasetya Budi, Suwanto, Denny, Rachmi, Dita Aulia, Yogiarto, Mohammad
Format: Article
Language:English
Subjects:
Anemia
Autopsies
Case Report
Case reports
Chemotherapy
Dyspnea
Effusion
Electrolytes
Head & neck cancer
Heart
Magnetic resonance imaging
Melanoma
Metastases
Metastasis
Oral cancer
Oral carcinoma
Pacemakers
Patients
Pleural effusion
Skin cancer
Thyroid gland
Tongue
Tumors
Ultrasonic imaging
Uterus
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Summary:Metastatic tumors of the heart presenting with complete heart block (CHB) is an extremely uncommon case. There are no available guidelines in managing CHB in terminal cancer. Permanent pacemaker implantation in such cases is a challenge in terms of clinical utility and palliative care. We report a case of a 24-year-old man suffering from tongue cancer presenting with CHB. An intracardiac mass and moderate pericardial effusion were present, presumed as the metastatic tumor of tongue cancer. We implanted a temporary pacemaker for his symptomatic heart block and cardiogenic shock, and pericardiocentesis for his massive pericardial effusion. We decided that a permanent pacemaker would not be implanted based on the low survival rate and significant comorbidities. Multiple studies report a variable number of cardiac metastasis incidence ranging from 2.3% to 18.3%. It is rare for such malignancies to present with CHB. The decision to implant a permanent pacemaker is highly specific based on the risks and benefits of each patient. It needs to be tailored to the patient's functional status, comorbid diseases, prognosis, and response to conservative management.
ISSN:2046-1402
2046-1402
DOI:10.12688/f1000research.26438.2