Left Ventricular Metastasis from Tongue Squamous Cell Carcinoma Presenting with Ventricular Tachycardia: A Case Report

Abstract Background Cardiac metastasis from tongue squamous cell carcinoma (TSCC) is extremely rare. Endocardial involvement, particularly in the left heart, occurs in only 3–6% of cases and is often asymptomatic until advanced stages. Early detection is challenging but critical to prevent life-threatening complications. Case Summary A 75-year-old man with a history of TSCC presented with non-sustained ventricular tachycardia (NSVT) detected during routine postoperative surveillance. Transthoracic and transesophageal echocardiography, cardiac magnetic resonance imaging, and contrast-enhanced CT revealed a well-defined mass in the left ventricular cavity infiltrating the anterolateral papillary muscle. Surgical excision with concomitant mitral valve replacement was performed. Histopathology confirmed metastatic TSCC. Postoperatively, ventricular arrhythmias resolved completely, and the patient remained recurrence-free with preserved cardiac function during follow-up. Discussion This case highlights the rare presentation of left-sided endocardial cardiac metastasis from TSCC manifesting as potentially life-threatening ventricular arrhythmias. It emphasizes the importance of considering cardiac metastasis in cancer patients with new-onset arrhythmias, demonstrates the diagnostic utility of multimodal imaging, and underscores the therapeutic benefit of timely surgical intervention in selected patients.