J Cardiovasc Ultrasound.  2012 Sep;20(3):157-160. 10.4250/jcu.2012.20.3.157.

Unusual Left Ventricular Endocardial Metastasis from Primary Lung Cancer

• Son JW
• Hong GR

• KMID: 1808353
• DOI: http://doi.org/10.4250/jcu.2012.20.3.157

Abstract

The heart is frequently the site of metastasis of various malignant tumors. Lung cancer is one of the most common primary tumors of cardiac metastasis and usually involves the pericardium or epicardium by direct invasion and/or lymphatic spread. However, metastasis of lung cancer involving the left ventricular endocardium is extremely rare. We report a patient with adenocarcinoma of lung, metastasized to the left ventricular myocardium and endocardium, diagnosed by echocardiography and 18-fludeoxyglucose positron emission tomography-computed tomography.

Keyword

Lung cancer; Metastasis; Left ventricle

MeSH Terms

Adenocarcinoma
Echocardiography
Electrons
Endocardium
Heart
Heart Ventricles
Humans
Lung
Lung Neoplasms
Myocardium
Neoplasm Metastasis
Pericardium
Adenocarcinoma
Lung Neoplasms

Figure

• 

  Fig. 1 Chest X-ray and computed tomography findings of lung lesion. Soft tissue fullness at right infra-hilar area and air-fluid level in right lower lung field (A). Cavitary lung mass with inner low density and multilocular effusion in the right lower lobe (B: white arrows) and multiple lymphadenopathies in right side mediastinum (C: white arrows).

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  Fig. 2 Transthoracic echocardiography findings of left ventricular mass in parasternal long axis (A) and apical 4 chamber view (B). Hyper-mobile, 2.4 cm × 1.4 cm sized mass is attached at interventricular septum of left ventricular outflow tract (white arrows). Apical long axis view (C) and zoom image (D) of left ventricular mass. Multi-lobulated, cystic nature mass with stalk (D: white arrow) is well visualized.

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  Fig. 3 18-fludeoxyglucose (FDG) positron emission tomography-computed tomography image of left ventricular mass and lung mass. The low density lesion in interventricular septum (A: black arrow) showed intense FDG uptake [B: white arrow, maximal standardized uptake value (SUVmax) = 13.9]. Primary lung cancer (SUVmax = 14.8) and multiple pleural metastasis also showed intense FDG uptake (B: white arrowheads). Coronal section image (C) showing multiple FDG uptake in primary lung cancer (white arrowhead), mediastinal lymph node (*), and the heart (white arrow).

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