Tricuspid valve metastasis and tumoural pulmonary embolism case report: a rare germ cell tumour manifestation

Cardiac metastases are a rare complication, with an incidence ranging from 2.3% to 18.3%. While secondary heart neoplasms are more common than primary ones, germ cell tumour (GCT) involvement is rare, with less than 30 cases reported globally. Mixed GCTs of gonadal location are a type of cancer that rarely metastasize the heart.

We present the case of a 31-year-old male with a history of testicular GCT. A few months after radical right orchiectomy, he developed respiratory distress and heart failure, associated with the presence of masses in the tricuspid valve and pulmonary branches. He was scheduled for tricuspid valve replacement surgery and removal of pulmonary masses. Histopathology determined a GCT: teratoma with immature and mature elements.

Metastatic lesions from GCTs can clinically mimic infective endocarditis or pulmonary embolism, potentially leading to diagnostic delays in oncological patients. The case highlights the importance of considering metastatic aetiology in cancer patients with cardiac masses for timely surgical intervention.