Abstract

Tumors metastatic to the heart (cardiac metastases) are among the least known and highly debated issues in oncology, and few systematic studies are devoted to this topic [1]. Cardiac metastases are considered to be rare; however, when sought for, the incidence seems to be not as low as expected [2]. This case presents a 68-year-old female patient with worsening cardiac function and stage 4 lung cancers. The transthoracic echocardiogram revealed mildly diminished left ventricular ejection fraction of 40-45%, as well as a low-density mass noted in the left atrium with the left interatrial septum intact. Later, a transesophageal echocardiogram was performed and it revealed a 3 x 1.5cm mass in the left atrium which was thought to originate from or near the right superior pulmonary vein. While therapy was showing favorable results towards the lung mass, a cardiac mass was eventually discovered, and treatment was limited due to its position and size. This case shows that cardiac metastases may not be as rare as the literature suggests and can be asymptomatic despite the massive loss of efficient contractile material. It may be practical to monitor for cardiac metastases in lung cancer patients to prevent further metastasis and help guide therapy.