To report a rare case of isolated cardiac metastasis from sarcomatoid urothelial carcinoma and evaluate the response to immunotherapy, highlighting its significance in the context of existing literature.
Key Findings:
The patient had a high-grade sarcomatoid urothelial carcinoma with a significant sarcomatoid component, emphasizing its aggressive nature.
Postoperative imaging revealed multifocal metastases, including a large right ventricular mass, underscoring the rarity of cardiac involvement.
Tislelizumab monotherapy resulted in progressive regression of the cardiac mass, suggesting a novel treatment avenue.
Interpretation:
This case suggests that immune checkpoint inhibitors may be an effective treatment option for patients with high PD-L1-expressing sarcomatoid urothelial carcinoma and cardiac metastasis, particularly when traditional therapies are not tolerated, warranting further investigation.
Limitations:
The case is a single patient report, limiting generalizability and raising questions about broader applicability.
Lack of definitive confirmation of metastatic etiology despite imaging regression, highlighting the need for further studies.
Conclusion:
This is the first documented case of isolated right ventricular metastasis from sarcomatoid urothelial carcinoma responding to anti-PD-1 therapy, highlighting a potential treatment avenue for similar cases.
