title: Myocardial metastasis of cutaneous squamous cell carcinoma in a renal transplant recipient.
abstract: Myocardial metastasis from a cutaneous squamous cell carcinoma (SCC) is rare. Herein we have presented a case of metastasis from cutaneous SCC to the myocardium in a renal transplant recipient, which was confirmed by a cardiac fine-needle biopsy. Postmortem examination revealed disseminated metastatic disease involving myocardium, lungs, thyroid, skin, and peritoneum secondary to cutaneous SCC likely related to immunosuppression. At 46 years of age, he received a renal transplant for chronic renal failure caused by chronic glomerulonephritis. He started to develop multiple nonmelanoma skin cancers 4 years later. At least 23 invasive SCCs and 14 basal cell carcinomas were excised. His immunosuppressive regimen consisted of cyclosporine (150 mg), azathioprine (75 mg), and prednisone (10 mg daily), which was not modified despite multiple nonmelanoma skin cancers. Our case report further illustrates the potentially aggressive and fatal nature of cutaneous SCCs that can develop in organ transplant recipients. It argues for modification of the immunosuppressive regimen in such patients. The management of renal transplant patients with nonmelanoma skin cancers remains difficult and complex.
authors.affiliation: Angiogenesis and Cancer Research Group, Department of Pathology, University of Otago, Christchurch School of Medicine, PO Box 4345, Christchurch 8140, New Zealand. kasia@mackenzies.co.nz
authors.forename: K A
authors.initials: KA
authors.lastname: Mackenzie
authors.forename: J W
authors.initials: JW
authors.lastname: Simcock
authors.forename: J G
authors.initials: JG
authors.lastname: Lainchbury
authors.forename: M J
authors.initials: MJ
authors.lastname: Currie
authors.forename: K L
authors.initials: KL
authors.lastname: Lynn
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D004452:Echocardiography; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery; D006338:Heart Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology*; D011183:Postoperative Complications / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents