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Cardiac metastases from primary carcinoma of the larynx

METASTASIS from squamous cell carcinoma of the larynx, other than to the cervical lymph nodes, is relatively uncommon. However, where increasing use is made of cytotoxic chemotherapy, the incidence of distant metastasis may be greater. In general, metastasis to the heart from distant tumours is rare although, in a series of 1,047 patients dying from a variety of disseminated malignancies, 14-1 per cent were shown to have cardiac metastases (Harrer and Lewis, 1970). However, this does not represent the overall rate of cardiac metastases, as it refers only to cases dying of advanced disease. In their series, 4 patients with primary laryngeal carcinoma were found at autopsy to have cardiac metastases, but in none was the cardiac metastasis necessarily the immediate cause of death. One of the 4 patients suffered a myocardial infarction but had also done so previously, prior to the development of his original laryngeal tumour, and he was on long-term medication for angina pectoris. Similarly, further occasional reports of cardiac metastasis from laryngeal carcinoma have appeared (Golyshev and Skrobot, 1975), but in none was the metastasis necessarily the direct cause of death. The following case is presented as we believe that it is the first report where a cardiac metastasis can be implicated as the immediate and direct cause of death.