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A bumpy road to the diagnosis of metastatic lung cancer
, 2, 3, 3
Affiliations- Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw, Poland
- Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Warsaw
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Abstract
Cardiac tumors pose the uncommon group of disorders and most of them are metastases. They are generally localized in the left heart and may present with non-specific symptoms. Diagnosis may be often difficult due to the presence other heart diseases. The gold standard in diagnosing is non-invasive imaging. We present a case of a 77-year-old male admitted to our hospital due to flu symptoms, headaches and loss of weight in the last 2–3 weeks. The diagnostic process including computed tomography (CT) and magnetic resonance imaging revealed pathological contrast enhancement in the left parietal lobe, whereas subsequent transthoracic echocardiography disclosed a pathological oval mass 2.5 x 3.5 cm in the left heart suspected of a metastasis. Results of echocardiography turned the diagnostic process around and extended to bronchoscopy and abdominal CT. Finally, central left lung tumor with metastases to lungs, pleura, lymphoid nodes of the right hilar, left ventricle, left suprarenal gland and central nervous system was diagnosed.
Abstract
Cardiac tumors pose the uncommon group of disorders and most of them are metastases. They are generally localized in the left heart and may present with non-specific symptoms. Diagnosis may be often difficult due to the presence other heart diseases. The gold standard in diagnosing is non-invasive imaging. We present a case of a 77-year-old male admitted to our hospital due to flu symptoms, headaches and loss of weight in the last 2–3 weeks. The diagnostic process including computed tomography (CT) and magnetic resonance imaging revealed pathological contrast enhancement in the left parietal lobe, whereas subsequent transthoracic echocardiography disclosed a pathological oval mass 2.5 x 3.5 cm in the left heart suspected of a metastasis. Results of echocardiography turned the diagnostic process around and extended to bronchoscopy and abdominal CT. Finally, central left lung tumor with metastases to lungs, pleura, lymphoid nodes of the right hilar, left ventricle, left suprarenal gland and central nervous system was diagnosed.
Keywords
cardiac tumor, non-invasive imaging, transthoracic echocardiography, metastasis, cardiac metastasis
About this articleTitle
A bumpy road to the diagnosis of metastatic lung cancer
Journal
Issue
Article type
Case report
Pages
211-214
Published online
2020-06-24
Page views
535
Article views/downloads
629
DOI
Bibliographic record
Medical Research Journal 2020;5(3):211-214.
Keywords
cardiac tumor
non-invasive imaging
transthoracic echocardiography
metastasis
cardiac metastasis
Authors
Olga Możeńska
Michał Wojewódzki
Robert J. Gil
Jacek Bil
References (11)- Hudzik B, Miszalski-Jamka K, Glowacki J, et al. Malignant tumors of the heart. Cancer Epidemiol. 2015; 39(5): 665–672.
- Hirsch FR, Scagliotti GV, Mulshine JL, et al. Lung cancer: current therapies and new targeted treatments. Lancet. 2017; 389(10066): 299–311.
- Bussani R, De-Giorgio F, Abbate A, et al. Cardiac metastases. J Clin Pathol. 2007; 60(1): 27–34.
- Petris AO, Alexandrescu DM. Costache, II: Cardiac tumors. Rev Med Chir Soc Med Nat Iasi. 2014; 118(2): 289–292.
- Akishima S, Umezu Y. [Three cases of cardiac tumor; an approach to excise a large tumor in the left atrium]. Kyobu Geka. 2014; 67(12): 1075–1078.
- Ragland MM, Tak T. The role of echocardiography in diagnosing space-occupying lesions of the heart. Clin Med Res. 2006; 4(1): 22–32.
- Reynen K, Köckeritz U, Strasser RH. Metastases to the heart. Ann Oncol. 2004; 15(3): 375–381.
- Mkalaluh S, Szczechowicz M, Torabi S, et al. Surgical Treatment of Cardiac Metastases: Analysis of a 13-Year Single-Center Experience. Thorac Cardiovasc Surg. 2019; 67(8): 659–664.
- Hoffmeier A, Sindermann JR, Scheld HH, et al. Cardiac tumors--diagnosis and surgical treatment. Dtsch Arztebl Int. 2014; 111(12): 205–211.
- Palaskas N, Thompson K, Gladish G, et al. Evaluation and Management of Cardiac Tumors. Curr Treat Options Cardiovasc Med. 2018; 20(4): 29.
- Jassem J. Cancer of the lung, pleura and mediastinum. Oncology in Clinical Practice. 2019; 15(1).