Stalactites in the Right Ventricle.

Area of Science:

• Cardiology
• Oncology
• Radiology

Background:

• Cardiac metastasis is more common than primary heart tumors, often arising from lung cancer via direct spread.
• While frequently asymptomatic, cardiac metastases can manifest as arrhythmias, ECG changes, or myocardial infarction mimicry.

Observation:

• A rare case of pulmonary adenocarcinoma presented with a large, stalactite-shaped metastasis in the right ventricle (20x34x12 mm).
• This metastasis caused significant compression of the right pulmonary trunk, leading to pulmonary hypertension.

Findings:

• The tumor embolized, causing a massive pulmonary embolism, a critical complication in right-sided cardiac lesions.
• Multimodality imaging is crucial for characterizing cardiac metastasis.

Implications:

• This case underscores the potential for cardiac metastasis to cause fatal pulmonary embolism, even with thrombolytic therapy.
• Accurate diagnosis and characterization of cardiac tumors through advanced imaging are vital for patient management and prognosis.