RATIONALE: Cardiac metastasis is known as a rare complication of head and neck malignancy. PATIENT CONCERNS: We present a 58-year-old woman patient with a history of tongue carcinoma who was admitted in emergency department for sudden chest pain. Imaging work-up by computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) diagnosed a cardiac metastasis complicated by intraventricular thrombus and pulmonary embolism. DIAGNOSIS: Cardiac metastasis from tongue carcinoma complicated by pulmonary embolism. INTERVENTIONS: After undergoing 2 cycles of palliative chemotherapy, the patient declined any further treatment. OUTCOMES: Patient died 3 months after the diagnosis of cardiac metastasis. LESSONS: Cardiac metastasis should be considered as a differential diagnosis in patients with a history of head and neck malignancy who present non-specific cardiac symptoms.
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