Effectiveness of Enfortumab-Vedotin for Right Atrial Metastasis Following Total Cystectomy: A Case Report

Cardiac metastases from bladder cancer are extremely rare and typically associated with a poor prognosis. We here report a case of a 74-year-old woman who had been diagnosed with multiple bladder cancer and later developed pelvic recurrence and multiple bone metastases. Second-line pembrolizumab treatment achieved complete remission. Three years and three months after the second-line pembrolizumab treatment, a routine computed tomography scan revealed a right atrial mass and bilaterally enlarged adrenal glands. Primary tumors were not identified, suggesting that the tumor in the right atrium and the enlargement of the adrenal glands were recurrences of the previous bladder cancer. Enfortumab-vedotin (EV) was chosen as a subsequent treatment. One month after this treatment, the tumor in the right atrium was undetectable and her adrenal glands had shrunk. Her complete response was maintained six months after starting subsequent treatment. To the best of our knowledge, this is the first case report of complete remission of bladder cancer metastasis to the right atrium induced by EV.