A Rare Presentation of Lung Carcinoma: Cardiac Metastasis With Left Atrial Involvement Through the Pulmonary Veins

Document Type : Case Report

Authors

1 Department of Cardiology, Kasturba Medical College, Manipal Academy of Higher Education, Karnataka, India.

2 Department of Respiratory Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Karnataka, India.

3 Department of Cardiovascular Technology, School of Allied Health Science (SOAHS), Manipal Academy of Higher Education, Manipal, India.

Abstract

Lung cancers can extend along or grow through the pulmonary veins to invade the left atrium. A 51-year-old man, previously healthy, presented with left-sided chest pain, dry cough, and dyspnea of 2 months’ duration. The patient also had a history of weight loss and decreased appetite. On physical examination, he had tachycardia and tachypnea. Cardiac examination revealed normal heart sounds and no murmurs. Auscultation of the chest revealed diminished breath sounds in the left hemithorax. Chest radiography showed a left-sided massive pleural effusion. A computed tomography scan confirmed the radiographic findings with a mass extending along the pulmonary vein into the left atrium, suggestive of tumor thrombosis. Transthoracic and transesophageal echocardiographic examinations revealed a mass within the left atrium, measuring about 1.9×1.6 cm at its largest diameter. This case report has 2 primary justifications, considering the rarity and the poor outcome. (Iranian Heart Journal 2021; 22(4): 148-155)

Keywords

References

  1. O'Mahony D, Peikarz RL, Bandettini WP, Arai AE, Wilson WH, Bates SE. Cardiac involvement with lymphoma: a review of the literature. Clin Lymphoma Myeloma. 2008 Aug; 8(4):249-52. doi:10.3816/CLM.2008.n.034. PMID:18765314; PMCID: PMC2998057.
  2. Bussani R, De-Giorgio F, Abbate A, Silvestri F. Cardiac metastases. J Clin Pathol. 2007; 60(1):27–34. DOI: 10.1136/jcp.2005.035105.
  3. Giuffrida D, Gharib H. Cardiac metastasis from primary anaplastic thyroid carcinoma: Report of three cases and a review of the literature. Endocr Relat Cancer 2001; 8:71‑3
  4. Mehan VK, Deshpande J, Dalvi BV, et al. Direct extension of bronchogenic carcinoma through pulmonary veins into the left atrium mimicking left atrial myxoma. Chest 1992; 101:1722-3. DOI: 10.1378/chest.101.6.1722
  5. Guha P, Sardar P, Mookerjee S, et al. Left atrial extension of lung carcinoma simulating myocardial infarction, unusual presentation: case report and literature review. Tanaffos 2011; 10:69-71.
  6. Kadappu KK, Rajaratnam R, Kachwalla H, et al. Lung cancer mimicking left atrial mass. Postgrad Med J 2008; 84:386-7. DOI:10.1136/pgmj.2008.067934
  7. Campos P, D'Cruz IA, Dweik HW, et al. Posterior mediastinal spread of bronchogenic carcinoma simulating a mass within the left atrium. Echocardiography 2004; 21:341-3. DOI: 10.1111/j.0742-2822.2004.03115.x
  8. Lestuzzi C, Viel E, Mimo R, et al. Left atrial invasion by lung carcinoma through a pulmonary vein. Int J Cardiovasc Imaging 2001; 17:107-10. DOI:10.1023/A:1010621320976
  9. Desai MY, Mankad S. Extension of bronchogenic carcinoma through pulmonary vein into the left atrium detected by echocardiography. Echocardiography 2004; 21:189-91. DOI:10.1111/j.0742-2822.2004.02178.x
  10. Watanabe N, Kubo K. Images in cardiology: Intra-left atrial invasive mass extended via the pulmonary vein. Heart. 2001; 85(3):271. DOI:10.1136/heart.85.3.271
  11. Cipriano F, Dessoti LU, Rodrigues AJ, Vicente WVA, Chahud F, Evora PRB. A report of a lung carcinoma extended to the left atrium through the pulmonary vein. J Thorac Dis. 2018; 10(1): E46-E51.
  12. Borsaru AD, Lau KK, Solin P. Cardiac metastasis: A cause of recurrent pulmonary emboli. Br J Radiol 2007; 80:e50‑3.
  13. Hiremath R, KC A, Noronha GP, Naik SB, Tejasvi S. Metastatic cardiac tumor from bronchogenic carcinoma via pulmonary vein: A case report. J Clin Diagn Res 2013;7:2600‑1
  14. Mihali E, Muresan M, Rusu ML, Fodor D. Cardiac metastasis, and tumor embolism in a patient with adenocarcinoma of the colon presenting with paraneoplastic polymyositis. Rom J Morphol Embryol 2013; 54 3 Suppl: 897‑900.
  15. Chiles C, Woodard PK, Gutierrez FR, Link KM. Metastatic involvement of the heart and pericardium: CT and MR imaging. Radiographics 2001; 21:439‑49.
  16. Chandra R, Abugroun A, Goldberg A, Cooney E, Mehrotra S, Volgman A. Small Cell Lung Cancer Invading the Left Atrium With Subsequent Malignant Embolic Stroke: A Case Report and Review of Literature. Cardiol Res. 2019; 10(3):188-192. DOI:10.14740/cr752w
  17. Spaggiari L, M DA, Veronesi G, Pelosi G, de Pas T, Catalano G, de Braud F. Extended pneumonectomy with partial resection of the left atrium, without cardiopulmonary bypass, for lung cancer. Ann Thorac Surg. 2005; 79(1):234–240
Iranian Heart Journal
Volume 22, Issue 4
October 2021
Pages 148-155

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