Extension to the Heart of Metastatic Lung Cancer Presenting as Acute Neurological Syndrome: The Key Role of Echocardiography

Abstract

Metastatic cardiac malignancies are significantly more common than primary cardiac tumors. Primary lung cancers often invade the heart locally and they can also spread to the heart via the blood, lymphatic system or both; in contrast, an extension to the left atrium from the pulmonary vein is very rare. Here, we report a case of a 79-year-old man with an acute neurological syndrome, in which an integrated multimodality imaging approach has allowed to discovery a lung cancer with cerebral embolism and intracavitary heart dissemination through the left superior pulmonary vein.

Keywords: Acute neurological syndrome; cerebral embolism; left atrial mass; lung cancer.

Figure 1

Multiplanar transesophageal echocardiogram shows the mass (a) coming from the left superior pulmonary vein (b and c) and prolapsing into the left atrium (d)

Figure 2

(a and b) Brain magnetic resonance imaging T2-weighted axial images (for explanations, please see the text). (c) Axial unenhanced computed tomography scan shows a left inferior pulmonary lobe solid mass that infiltrates left pulmonary veins and left atrium (white arrows)