PMC9262084_01
Histological examination of the tumor. A. vulvar keratinizing squamous cell carcinoma, well differentiated (HE, x400); B. p16 negative in tumor cells (IHC, anti-p16 Ab, x200); C. Negative p53 in tumor cells (IHC, anti-p53 Ab, x200).
acc-09-02-62-g001.jpg
PMC9262084_01_acc-09-02-62-g001.jpg
f1
It identified vulvar keratinizing squamous cell carcinoma, well-differentiated (G1), unassociated with HPV infection, p16 and p53 negative (Figure 1).
Giant metastases in the right ventricle 50/41 mm (subcostal view).
acc-09-02-62-g002.jpg
PMC9262084_01_acc-09-02-62-g002.jpg
f2
The transthoracic echocardiography in the emergency room revealed, from the subcostal view, two great inhomogeneous masses in the right ventricular free wall and from the apical 4-chamber view another great inhomogeneous mass in the lateral left ventricular wall, with pericardial invasion (Figure 2).
Cardiac Computed Tomography with contrast. A. Coronal section of the heart-lesions in the left ventricle (arrow). B. Axial section - metastasis in both parts of the heart (arrows).
acc-09-02-62-g003.jpg
PMC9262084_01_acc-09-02-62-g003.jpg
f3
Treatment history and timing onset of cardiac symptoms of a metastatic vulvar cancer patient.
acc-09-02-62-g004.jpg
PMC9262084_01_acc-09-02-62-g004.jpg
f4
Figure 4 summarizes the sequence of the patient's disease over time, including the treatments performed.