The only other case of cardiac oligometastases from MCC treated with SABR was reported by Kazemi et al. and described a patient who presented with second-degree heart block secondary to an intra-arterial mass and was treated with anti-programmed cell death ligand 1 (PD-L1) immunotherapy with avelumab and concurrent radiotherapy to a dose of 40 Gy given in five daily fractions using intensity modulated radiotherapy [10]. This evidence concerns the gene CD274 and Merkel cell skin cancer.