We describe a man who was diagnosed with non-small cell lung cancer following previous treatment for small cell lung cancer. He developed dyspnoea, paroxysmal nocturnal dyspnoea and orthopnoea. Trans-thoracic echocardiogram revealed a large mass within the right atrium. The patient proceeded to thoracotomy at which time unresectable metastatic tumour was found in the right atrium infiltrating into the pericardium. Metastatic involvement of the heart by tumour is rare and is found at autopsy in 1–3% of unselected cases in various series. This translates into a finding of cardiac metastases in approximately 10% of autopsies where malignancy is diagnosed. Most cases are clinically silent and are undiagnosed in vivo. Echocardiography, CT and MRI are complementary investigations, and are all used in the evaluation of cardiac lesions. When metastatic disease is in question, MR and CT imaging offer advantages over echocardiography, chiefly a wider imaging field which allows evaluation of distant disease.
Lung cancer Cardiac Metastasis Echocardiography MRI
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Lam KY, Dickens P, Chan AC (1993) Tumours of the heart. A 20-year experience with a review of 12, 485 consecutive autopsies. Arch Pathol Lab Med 117(10):1027–1031PubMedGoogle Scholar
Butany J, Leong SW, Carmichael K, Komeda M (2005) A 30-year analysis of cardiac neoplasma at autopsy. Can J Cardiol 21(8):675–680PubMedGoogle Scholar
Abraham KP, Reddy V, Gattuso P (1990) Neoplasms metastatic to the heart: review of 3314 consecutive autopsies. Am J Cardiovasc Pathol 3(3):195–198PubMedGoogle Scholar
Klatt EC, Heitz DR (1990) Cardiac metastases. Cancer 65(6):1456–1459 10.1002/1097-0142(19900315)65:6<1456::AID-CNCR2820650634>3.0.CO;2-5PubMedCrossRefGoogle Scholar
Chiles C, Woodard PK, Gutierrez FR, Link KM (2001) Metastatic involvement of the heart and pericardium: CT and MR imaging. Radiographics 21:439–449PubMedGoogle Scholar