Medicine in Image
Multiple intracardiac metastases. Unexpected finding in the diagnosis of lung cancer
Metástasis intracardiacas múltiples. Hallazgo inesperado en el diagnóstico de cáncer de pulmón
F. Sabatel-Perez
, B. Santos González, L. Rodríguez-Padial
Corresponding author
Servicio de Cardiología, Complejo Hospitalario de Toledo, Toledo, Spain
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Unexpected finding in the diagnosis of lung cancer" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "319" "paginaFinal" => "320" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "F. Sabatel-Perez, B. Santos González, L. Rodríguez-Padial" "autores" => array:3 [ 0 => array:4 [ "nombre" => "F." "apellidos" => "Sabatel-Perez" "email" => array:1 [ 0 => "fernandosabatelperez@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "B." "apellidos" => "Santos González" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Rodríguez-Padial" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Cardiología, Complejo Hospitalario de Toledo, Toledo, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Metástasis intracardiacas múltiples. Hallazgo inesperado en el diagnóstico de cáncer de pulmón" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 846 "Ancho" => 1500 "Tamanyo" => 209448 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 70-year-old man was admitted to the emergency department for symptoms of cough, hemoptysis, dyspnea and constitutional syndrome. Chest radiography revealed a left parahiliar mass (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A, white arrow). Suspecting lung cancer, we requested computed axial tomography (CAT), which revealed a mass suggestive of pulmonary neoplasia, with several intracardiac masses and impairment of the left pulmonary veins (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B and <span class="elsevierStyleSmallCaps">C</span>, white asterisk, white arrow primary tumor). These masses were confirmed with transthoracic ultrasonography, at the apex of the left ventricle and the interventricular septum (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D, white asterisks). We suspected that these masses were intracavitary thrombi or metastases. Subsequent cardiac magnetic resonance imaging (C-MRI) suggested a metastatic origin for the intracardiac masses, probably by a hematogenous pathway given the observed infiltration of the pulmonary veins (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>E, white asterisks, white arrow primary tumor). Ultimately, the pathological study of the endobronchial biopsy confirmed the diagnosis of pulmonary adenocarcinoma (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>F).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Metastatic or secondary cardiac tumors are almost 30 times more common than primary tumors and have an incidence rate approaching 13% in series of autopsies of malignant tumors. Approximately 28% of the tumors are diagnosed in patients with lung cancer. For the diagnosis, echocardiography is the main tool. CAT and C-MRI are useful for defining the tumor anatomy and invasion of cardiac structures. Treatment consists of surgical resection, although the tumors usually have a poor prognosis, and most treatments are palliative.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Authorship</span><p id="par0015" class="elsevierStylePara elsevierViewall">Concept and design of the manuscript: Fernando Sabatel-Perez.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Data collection: Fernando Sabatel-Perez and Belén Santos González.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Data analysis and interpretation: Fernando Sabatel-Perez.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Drafting, review and approval of the submitted manuscript: Fernando Sabatel-Perez, Belén Santos González and Luis Rodríguez-Padial.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Authorship" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-10-11" "fechaAceptado" => "2018-11-01" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sabatel-Perez F, Santos González B, Rodríguez-Padial L. Metástasis intracardiacas múltiples. Hallazgo inesperado en el diagnóstico de cáncer de pulmón. 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