Cardiac Mass Revealing an Infiltrating Bronchogenic Carcinoma Reaching the Controlateral Upper Lobe: A Case Report

Abstract

Abstract: A malignant tumor can invade all organs of the body by different ways, cardiac metastases of bronchial origin are generally less frequent, and there are few cases in the literature. We report a case of an intra-cardiac tumor revealing a bronchial carcinoma. We report the case of a 64-year-old man who was a smoker at 40PA. He presented with a 3 months evolving symptomatology made of dyspnea associated to a productive cough with whitish sputum sometimes streaked with blood. The patient also complained of a retrosternal pain irradiating to the interscapular region. The patient was apyretic but presented anorexia and weight loss. On physical examination, the patient had a tachycardia at 100 beats per minute, a right basal fluid effusion syndrome, with a WHO performance status at 1.The electrocardiogram showed sinus tachycardia at 100 bpm with the presence of some ventricular extrasystoles. The cardiac echocardiography showed a hypoechoic mass in the left atrium attached to the upper wall, The thoracic CT scan showed a locally invasive heterogeneous tumor, localized in the right lower pulmonary lobe and the mediastinum with intracardiac extension to the left atrium. The bronchoscopy showed a friable whitish tumor bud obstructing the right stump bronchus bleeding on contact, with another bud obstructing the segmental bronchus of the left upper lobar bronchus bleeding easily on contact, biopsies of the bud and aspirations for cytodiagnosis were performed.