Intracardiac metastasis of immature teratoma after chemotherapy in a patient with testicular mixed germ cell tumor

Cancer with intra-cardiac metastasis is a rare complication. We herein report a 32-year-old male diagnosed with stage IV mixed germ cell tumor of the testes who received right radical orchiectomy. Initially, he had right lung metastasis and a mediastinal lymph node attached to the right side of the heart. After four cycles of chemotherapy (bleomycin, etoposide, and cisplatin), the patient experienced sudden cardiac arrest. He was later found to have intra-cardiac metastasis with tumor invasion in the right pulmonary artery/veins, left atrium, and left ventricle. The patient subsequently received surgical intervention, and pathology revealed only immature teratoma. This study illustrates the proposition that chemo-resistant residual teratoma can still invade the heart after chemotherapy, and therefore surgical intervention might be needed.