The tell-tale heart: A case of recurrent vulvar carcinoma with cardiac metastasis and review of literature

Publication date: Available online 3 June 2017 Source:Gynecologic Oncology Reports Author(s): Syed Imran Mustafa Jafri, Naveed Ali, Salman Farhat, Faizan Malik, Mark Shahin A 50-year-old female was diagnosed with vulvar cancer treated with left partial vulvectomy and bilateral lymphadenectomy. Ten months after her surgery, she presented with increased labial swelling, pain and discharge. Biopsy confirmed recurrence of squamous cell vulvar carcinoma. Incidentally, on restaging radiographic scans, she was found to have a large right ventricular mass which, after surgical debulking, was shown to be a squamous cell cancer of vulvar origin. She was commenced on chemotherapy with carboplatin and paclitaxel along with concurrent radiation therapy. Restaging PET scan showed persistent metastatic disease. She was switched to Cisplatin/Taxol after having hypersensitivity reaction to Carboplatin. She received 5cycles with progression of disease in the follow up scans. She then received Nivolumab for 2cycles. The patient then opted for comfort directed care given worsening functional status and progression of disease on repeat imaging. Secondary cardiac tumors are very rare and not 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 two cases have been reported in the literature. However, vulvar cancer metastasizing to the right ventricular cavity and endocardium has not b...
Source: Gynecologic Oncology Reports - Category: OBGYN Source Type: research