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A 64-year-old man presented to our hospital with abnormalities on electrocardiogram
(ECG). Two years prior, he had undergone surgical resection for oesophageal carcinoma
at another hospital. Electrocardiogram performed at our hospital revealed sinus rhythm
with deep T-wave inversions in the precordial leads (Figure 1A ). He had no symptoms, including chest pain, dyspnoea, palpitation, or loss of consciousness.
Transthoracic echocardiography revealed a large mass extending from the ventricular
septum to the apex. Cardiac magnetic resonance imaging revealed a high-signal mass
with late gadolinium enhancement in the region of interest (Figure 1B, Supplementary data). The imaging findings suggested a cardiac tumour; thus, we
performed diagnostic coronary angiography and biopsy. Coronary angiography revealed
occlusion of the distal segment of the left anterior descending artery, which might
have been caused by compression by the cardiac mass (Figure 1C). Pathological findings and p63 positive cells of immunohistochemical study indicated
squamous cell carcinoma (Figure 1D). Positron emission tomography/computed tomography revealed no evidence of metastasis
in other organs or lymphoid nodes, except for the heart. Although metastatic cardiac
tumours occur 30 times more frequently than primary cardiac tumours [
], our report is the first documentation of the incident of coronary artery compression
caused by myocardial metastasis of oesophageal squamous cell carcinoma.
Figure 1A: Electrocardiogram on admission, B: Cardiac MRI images, C: Coronary angiogram, D:
Pathological images of cardiac mass.
