Cardiac Metastasis From Lung Cancer: A Hidden Cardioembolic Source of Acute Ischemic Stroke

Acute ischemic stroke requires prompt identification of the underlying mechanism to guide treatment and secondary prevention. Although common causes account for most cases, occasionally the diagnostic work-up reveals an unexpected cardioembolic source. We report the case of a woman in her 50s with stage IVB non-small cell lung carcinoma who was admitted with presyncope, acute disorientation, and dysarthria, followed by anomia and right-sided neurological deficits. Brain magnetic resonance imaging revealed multiple acute ischemic infarcts in the left middle cerebral artery territory. Cardiac imaging identified a left ventricular mass highly suggestive of cardiac metastasis, considering the probable source of cerebral embolism. Despite treatment, her condition progressively deteriorated, and she died one year later. This case highlights cardiac metastasis as a rare but important cause of cardioembolic stroke in patients with active cancer and emphasizes the value of multimodal cardiac imaging in identifying unusual embolic sources.