Mayo Clinic Proceedings: Innovations, Quality & Outcomes (Dec 2019)

Heart Block Caused by Cardiac Metastasis From Merkel Cell Carcinoma: A Case Report

  • Nazanin Yeganeh Kazemi, BS,
  • Christopher Jain, MD,
  • Melanie C. Bois, MD,
  • Atta Behfar, MD, PhD,
  • Kenneth Olivier, MD,
  • Svetomir N. Markovic, MD, PhD

Journal volume & issue
Vol. 3, no. 4
pp. 510 – 516

Abstract

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Merkel cell carcinoma (MCC) is a rare, rapidly proliferating skin cancer that commonly metastasizes to regional lymph nodes. We present the case of a 73-year-old woman with a history of MCC and non-Hodgkin B-cell lymphoma who presented with second-degree heart block (Mobitz type II) caused by an interatrial mass. Temporary pacing was required before biopsy, which revealed metastatic MCC. Treatment included permanent pacing, anti–programmed cell death ligand 1 immunotherapy, and radiation to the heart resulting in notable decrease in tumor size and normalized cardiac rhythm.