Mortality of patients who underwent percutaneous endoscopic gastrostomy appears to be high. In particular, the long-term prognosis was poor for patients with hypoalbuminemia, and this procedure is probably not preferred for patients with recurrent aspiration pneumonia.

Background. Cardiac metastasis from primary lung cancer is often found at autopsy, whereas clinical detection during life is difficult. Case. A 77-year-old man was admitted with a chief complaint of right anterior chest pain. Subsequent chest X-ray and CT scan revealed a tumor in the left hilum, extending into the mediastinum. Atelectasis of the left upper lobe was also found. Biopsy of a mass in the anterior chest wall and cytology of the sputum yielded a diagnosis of squamous cell carcinoma of the lung (T4N3M1, Stage IV) . Echocardiography on admission demonstrated a nodular lesion in the left ventricle, which closely mimicked the shadow of myxoma. However, additional echocardiography showed that the nodular tumor changed its morphology and invaded into the ventricular wall. In addition, further tumor was detected in the left atrium. Thus, the cardiac tumors were considered to be metastases, which confirmed on autopsy. Conclusion. In this case, cardiac metastasis of lung cancer showed a unique in its echography pattern, which was difficult to distinguish from myxoma. In addition, myocardial metastasis is relatively rare, and in this case was proved by autopsy. In the presence of any malignancy, diagnosis of cardiac tumors requires careful consideration. (JJLC. 2004;44:19-24) KEY WORDS -Primary lung cancer, Metastatic cardiac tumor, Cardiac myxoma

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