J Med Cases

Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc

Journal website https://www.journalmc.org

Case Report

Volume 14, Number 4, April 2023, pages 111-117

Primary Squamous Cell Lung Cancer With Frequent Episodes of Sustained Ventricular Tachycardia due to Myocardial Metastasis

Figures

Figure 1. Contrast-enhanced computed tomography of the chest on admission. A 65 × 45 mm lesion with a heterogeneous contrast effect in S¹⁺² in the left upper lobe was observed. Tumor invasion was observed in the chest wall.

Figure 2. (a) The 12-lead electrocardiogram on admission. Poor R wave progression was observed in leads V1-3, and negative T waves in leads III, aVF, V1-4. (b) Electrocardiographic monitoring at the onset of sustained ventricular tachycardia. Wide QRS tachycardia with a heart rate of 160 beats per minute (bpm) was observed.

Figure 3. (a) Transthoracic echocardiography: a hypoechoic tumor in the right ventricular cavity was observed (arrow). (b) Contrast-enhanced computed tomography of the heart: a 35 × 33 mm hypodense tumor with indistinct borders was observed in the right ventricular wall and ventricular septum. Cardiac magnetic resonance imaging in a sagittal view: a tumor with high intensity on fat-suppressed T2-weighted images (c) and with isointensity to the myocardium on T1-weighted images (d) was observed in the right ventricular wall (arrow).

Table

**Table 1.** Summary of the Reported Cases of Cardiac Metastasis Causing VT in Patients With Lung Cancer
No.	Age/gender	Histology	Location	PE	Diagnostic procedure	Distant metastasis	Treatment	Survival time from the diagnosis of VT	Reference
M: male; F: female; Sq: squamous cell carcinoma; Adsq: adenosquamous carcinoma; Ad: adenocarcinoma; RV: right ventricle; LV: left ventricle; PE: pericardial effusion; TTE: transthoracic echocardiography; CT: computed tomography; MRI: magnetic resonance imaging; FDG-PET: 18-fluorodeoxyglucose positron emission tomography; ADR: adrenal gland; RT: radiotherapy; VT: ventricular tachycardia.
1	66/M	Sq	RV	-	TTE, CT	Brain	Amiodarone, RT	2 months	[16]
2	49/F	Adsq	LV	+	TTE, MRI	Lung	Cardioversion, amiodarone	18 months	[17]
3	67/F	Sq	RV	+	TTE, MRI	Brain, bone	Amiodarone	5 months	[18]
4	66/F	Ad	LV	-	MRI, FDG-PET	-	Propranolol, RT	18 months (alive)	[19]
5	56/F	Sq	LV	-	TTE, CT, MRI	Bone, ADR lung, liver	Cardioversion	3 weeks	Present case