Unusual mass in the heart: A case report

Carcinoma lung is a concerning cause of mortality worldwide. Approximately half of the cases are metastatic at diagnosis and uncommon metastatic sites confer a worse prognosis. Intracardiac metastasis from lung cancer is rare and limited to a few case reports. The authors describe the case of a 54-year female with left ventricular cavity mass as one of the rarest presentations of lung malignancy. She presented to the cardiology outpatient department with a history of progressive dyspnea for the last two months. Her 2D echocardiogram showed a large heterogeneous mass in the left ventricle cavity along with gross pericardial and pleural effusion. CT guided lung biopsy revealed adenocarcinoma of the lung. The patient was started on tablet geftinib along with other supportive therapy, while awaiting reports of next generation sequencing (NGS) for mutation analysis and immunohistochemistry. However, the patient's condition rapidly worsened and she succumbed to death within one week of hospital admission. Cardiac metastasis is one of the rarest sites for lung cancer spread. Intracavitary metastasis as in our case is an extremely rare presentation. Treatment is not yet well defined for such cases and it carries a poor prognosis despite available therapies. This case required multidisciplinary approach with involvement of cardiologist, oncologist, pulmonologist and intensivists. Further research is required to help define better treatment options.