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To the Editor.
—I was glad to read the clinical note by William V. Harrer and Paul L. Lewis on "Cardiac Metastases of Laryngeal Carcinoma" (Arch Otolaryng91:382, 1970) A similar case reported by W. Meyer and myself was not accepted for publication by the Archives some years ago. A 67-year-old man died one year after laryngectomy for subglottic carcinoma grade III, from a hemorrhage into the buttock, which was most likely caused by afibrinogenemia. At autopsy a single metastasis was found in the myocard of the right ventricle infiltrating the septum and reaching the pulmonary ostium. Preoperative electrocardiographs showed normal results. One month before death the ECG showed sinus arrhythmia and all typical features of a fresh myocardial infarction.We certainly agree with the authors that metastases to the myocard should be considered when cardiac symptoms arise in a patient with laryngopharyngeal carcinoma.