[Diagnosis of a metastatic valvular tumor in a living patient].
BACKGROUND
The discovery of an endocardial mass always raises the question of its nature. Infectious endocarditis is the most frequent cause, but others diagnoses must be considered.


METHODS
We report a case of endocardial metastasis originating from an upper respiratory tract epidermoid carcinoma in a 48-years-old man. The diagnosis was established while the patient was alive, and survival at the time of writing is 8 months. This case report provides an opportunity for discussion of the differential diagnosis when confronted with an endocardial tumor, i.e. bacterial endocarditis, non-bacterial thrombotic endocarditis, primary cardiac tumors, metastatic osteogenic sarcoma and Libman-Sachs endocarditis.


CONCLUSIONS
Non bacterial thrombotic endocarditis and valvular metastasis should be considered upon discovery of a valvular tumor, in the context of neoplastic disease. The prognosis of endocardial metastasis is poor, but early diagnosis and appropriate management should eventually prolong survival.
Pulcini
C
C
Service de maladies infectieuses et tropicales, hôpital de l'Archet 1, centre hospitalier universitaire de Nice, 151, route Saint-Antoine-de-Ginestière, BP 3079, 06202 Nice cedex 3, France.
Vandenbos
F
F
Bernard
E
E
Roth
S
S
Elbeze
J-P
JP
Dunais
B
B
Peyrade
F
F
Dellamonica
P
P
D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002545:Brain Ischemia / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000139:chemically induced* / Q000556:secondary* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003221:Confusion / Q000209:etiology; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis; D005472:Fluorouracil / Q000008:administration & dosage; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000556:secondary* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D010039:Otorhinolaryngologic Neoplasms / Q000473:pathology*; D010291:Paresis / Q000209:etiology; D011379:Prognosis; D014717:Vertigo / Q000209:etiology
D000964:Antimetabolites, Antineoplastic; D002945:Cisplatin; D005472:Fluorouracil