Marwah Abdulrahman, Ahmed Abdlkadir, Nouraldeen Al-Zorgan, Bara'a Bashabsheh, Akram Al-Ibraheem
Cardiac metastases are uncommon, particularly in the left ventricle, where lesions often remain asymptomatic and can be easily overlooked on conventional imaging. Lung cancer, a leading cause of global cancer-related morbidity and mortality, accounts for approximately one-third of all cases of cardiac metastases among various malignancies. We present a 62-year-old male with stage IV squamous cell carcinoma of the lung, who exhibited widespread systemic metastases. Staging Fluorine-18 Fluorodeoxyglucose (¹⁸F-FDG) Positron Emission Tomography/Computed Tomography (PET/CT) revealed a hypermetabolic cavitary left upper lobe mass with a metastatic process involving multiple nodal, adrenal, hepatic, osseous, and cerebral deposits, along with an incidental focal FDG-avid lesion in the left ventricle that was not detected on initial CT. Echocardiography confirmed preserved cardiac function with a normal ejection fraction. Given uncommon nature of left ventricular involvement by squamous cell carcinoma and the limited number of similar reported cases, our findings contribute to the growing evidence supporting the critical role of ¹⁸F-FDG PET/CT in detecting clinically silent occult cardiac metastasis.