case_images: PMC11626642_01
case_images: Panel A: Frontal view of primary lesion involving the right side of the tongue (red arrow). Panel B: Sagital view of primary lesion involving the right side of the tongue (red arrow). Panel C: Frontal view showing bilateral adenopathy (red arrowhead) and physiological cardiac uptake with no visible metastasis (red arrow).
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case_images: Biopsy identified a p16-negative squamous cell carcinoma with high PD-L1 expression (CPS > 50). 18F-FDG PET/CT imaging in July 2023 showed a hypermetabolic mass on the right side of the tongue with invasion into the right submandibular gland and focal bone invasion in the para-symphyseal region of the mandible, accompanied by bilateral necrotic adenopathy impinging on the right jugular vein (Fig. 1).
case_images: Panel A: Initial CT-scan showing an intraventricular mass (red arrow). Panel B: Echocardiography showing right ventricular lesion (red arrow). Panel C: Coronal view of initial 18F-FDG PET/CT showing primary cancer hypermetabolism (arrowhead) and cardiac metastasis (arrow). Panel D: Follow-up CT showing a marked regression in size of intracardiac lesion at 6 months after treatment initiation.
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case_images: A presurgical thoracic and neck CT scan revealed a right ventricular mass, suspected to be a thrombus (Fig. 2, Panel A). This prompted anticoagulation with unfractionated heparin (UFH), following echocardiography (Fig. 2, Panel B) and cardiological consultation. Additionally, significant progression of the primary lesion and multiple bilateral necrotic lymph nodes were observed (Fig. 2, Panel C). A follow-up thoraco-abdominal scan 6 months later indicated a reduction in the size of the right ventricular mass and primary lesion (Fig. 2, Panel D).