{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T05:10:15Z","timestamp":1779253815268,"version":"3.51.4"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>\n                    Cardiac metastases from urothelial carcinoma (UC) are rare and have a poor prognosis. A 36-year-old woman presented with\n                    <jats:italic>de novo<\/jats:italic>\n                    metastatic muscle-invasive bladder cancer, bulky retroperitoneal lymphadenopathy, and a large right ventricular mass nearly obliterating the cavity and extending to the pulmonary artery. Because of impending right ventricular outflow tract obstruction, urgent surgical debulking was performed; a friable tumor encasing the tricuspid valve filled the right ventricle, valve preservation was not feasible, and postoperative pacing was required. Transurethral resection of the bladder tumor showed high-grade UC with predominant (80%) squamous differentiation, while the cardiac lesion demonstrated a pure squamous phenotype with immunohistochemistry supporting urothelial origin. Given a very high tumor burden and postoperative cisplatin ineligibility, first-line enfortumab vedotin plus pembrolizumab was initiated, but the patient rapidly deteriorated with early radiologic progression and died ~8 weeks after diagnosis. This case illustrates the aggressive course of squamous-dominant metastatic UC with intracardiac involvement, the therapeutic trade-off of urgent cardiac surgery, and the limited evidence for enfortumab vedotin-based regimens in squamous-predominant disease.\n                  <\/jats:p>","DOI":"10.3389\/fonc.2026.1786375","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:46:00Z","timestamp":1779252360000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Cardiac metastasis from urothelial carcinoma with predominant squamous differentiation in a young woman: first reported case treated with enfortumab vedotin plus pembrolizumab"],"prefix":"10.3389","volume":"16","author":[{"given":"Alix","family":"Vansteeger","sequence":"first","affiliation":[{"name":"Institut Roi Albert II, Medical Oncology, Cliniques universitaires Saint-Luc","place":["Brussels, 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