Left Atrial Mass Invasion from Pulmonary Neoplasm Extension via the Right Upper Pulmonary Vein Presenting as Ipsilateral Stroke

Ballo, Piercarlo; Laureano, Raffaele; M, Briganti; Passaleva, Maria Teresa; Piani, Fiorella; Piga, Cecilia; Tatini, Stefano; Santoro, Giovanni Maria

doi:10.1155/2016/7084234

Cited by 11 publications

(12 citation statements)

References 31 publications

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“…According to Ballo and colleagues, the evolution towards cerebral stroke has rarely been reported. They described an atypical case of hematogenous metastatic invasion of the LA from pulmonary neoplasm extension presenting as an ipsilateral stroke (14). In the present case, the intracardiac and the pulmonary masses were similar on the microscopic examination.…”

Section: Discussionsupporting

confidence: 62%

Report of a lung carcinoma extended to the left atrium through pulmonary vein

et al. 2018

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Lung cancers may extend along or grow through the pulmonary veins to invade or lie within the left atrium (LA). A 62-year-old man, previously healthy, presented with 1-month ventilatory-independent right hemithorax back pain, dry cough and large effort dyspnea. He also referred weight loss of 12 kg in 10 months and denied hemoptysis. As antecedents, he smoked for 40 years and moderate daily alcoholism. On physical examination, the patient was in good general condition, hydrated and regular respiration at rest [blood pressure (BP) =120/80 mmHg; heart rate (HR) =90 bpm; respiratory rate (RR) =16 rpm]. Cardiac auscultation revealed two standard rhythmic sounds without murmurs. Pulmonary auscultation revealed a slightly diminished vesicular murmur in the lower 1/3 of the right hemithorax without adventitious noises. Chest radiography showed a mass over the right lower lung. A CT scan confirmed the radiography image with the mass extending along the right inferior pulmonary vein and a tumor in the LA. Transthoracic and transesophageal echocardiography revealed large mass within the LA (occupying almost the entire cavity), measuring about 10 cm × 3 cm at its largest diameter, prolapsing into the left ventricle. Bronchoscopy, head CT scan, and whole-body bone scintigraphy investigation did not show any distant metastasis. The patient was successfully operated removing the intracardiac and inferior pulmonary vein tumor with the aid of cardiopulmonary bypass, followed by a right inferior lobectomy carried out after 25 days. After 30 days from surgery presented seizures associated a brain metastasis evidenced by CT when adjuvant radio and chemotherapy was started. During the next 90 days, the clinical conditions worsened, and the patient died 4 months after the surgical treatment. The case report has two primary justifications, even considering the poor outcome: (I) rarity and (II) the possibility of the surgical treatment.

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Section: Discussionsupporting

confidence: 62%

Report of a lung carcinoma extended to the left atrium through pulmonary vein

et al. 2018

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“…8 Invasion of the left portion of the heart may thus cause several life-threatening cardiac complications including pulmonary venous flow obstruction, cardiac tamponade, ventricular arrhythmia, complete heart block, as well as myocardial infarction. 11 Intracavitary metastases may also result in peripheral embolization, mechanical hemolysis, or intracavitary obstruction. 1 Anyway, cardiac inflow obstruction or massive tumor embolization invading vital organs can lead to sudden cardiac death.…”

Section: Discussionmentioning

confidence: 99%

“…Invasion of the LA may be thus taken into account as a catastrophic event which has not been often approached surgically. 11 As a result, use of cisplatin plus etoposide has been advocated to be effective for poorly differentiated large-cell neuroendocrine carcinomas in adjuvant therapy settings. Nevertheless, these results have been derived from retrospective studies.…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac invasion from bronchogenic carcinomas by the transvenous route is additionally a rare occurrence 8 . Invasion of the left portion of the heart may thus cause several life‐threatening cardiac complications including pulmonary venous flow obstruction, cardiac tamponade, ventricular arrhythmia, complete heart block, as well as myocardial infarction 11 . Intracavitary metastases may also result in peripheral embolization, mechanical hemolysis, or intracavitary obstruction 1 .…”

Section: Discussionmentioning

confidence: 99%

“…The metastatic pathway to the heart in lung cancer is usually lymphatic, but hematogenous routes may also occur although transvenous route occurs infrequently. Invasion of the LA may be thus taken into account as a catastrophic event which has not been often approached surgically 11 . As a result, use of cisplatin plus etoposide has been advocated to be effective for poorly differentiated large‐cell neuroendocrine carcinomas in adjuvant therapy settings.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Invasion of poorly differentiated large‐cell neuroendocrine tumor of the lung through right pulmonary veins into the left atrium: A very rare case report

Nosrati

Nabati

Vahedi

et al. 2020

J of Clinical Ultrasound

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Intracavitary cardiac metastasis is a rare manifestation of primary lung cancer which can be associated with a very poor prognosis. In this condition, the right chambers of the heart are more commonly involved and the invasion of the left atrium (LA) through the venous routes is highly exceptional. Poorly differentiated large-cell neuroendocrine tumors also include only 3% of all primary lung carcinomas which can have adverse outcomes. Therefore, in this report, a rare case of a 72-year-old male patient with poorly differentiated large-cell neuroendocrine carcinoma of the right lung spreading to the LA through the right pulmonary veins was described.

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Simultaneous bilateral pulmonary and cardiac invasion of metastatic testicular germ cell tumor: A rare case report

Riahi,

Pazoki,

Davani

et al. 2023

Sonography

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A 23‐year‐old man with a history of a testicular germ cell tumor (GCT) that was incompletely treated, is presented with dyspnea. Significant bilateral pulmonary masses were seen on computed tomography (CT). A large, hypermobile mass in the left atrium (LA) as well as mitral valve dysfunction and moderate pulmonary hypertension was detected by transthoracic echocardiography (TTE). Urgent cardiac surgery was performed to prevent the tumor embolism in addition to restore mitral valve function and reduce pulmonary hypertension. Pathologic reports confirmed testicular GCT. GCT metastasis to the heart and lungs is an incredibly rare phenomenon. To our knowledge, this is the first case of simultaneous GCT metastasis to both lungs and LA. This article highlights the importance of cardiac examinations and imaging in germ cell tumor patients. If there is a functional complication for vital organs such as the heart or lungs, surgical interventions are given priority before starting chemotherapy.

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Left Atrial Mass Invasion from Pulmonary Neoplasm Extension via the Right Upper Pulmonary Vein Presenting as Ipsilateral Stroke

Cited by 11 publications

References 31 publications

Report of a lung carcinoma extended to the left atrium through pulmonary vein

Report of a lung carcinoma extended to the left atrium through pulmonary vein

Invasion of poorly differentiated large‐cell neuroendocrine tumor of the lung through right pulmonary veins into the left atrium: A very rare case report

Simultaneous bilateral pulmonary and cardiac invasion of metastatic testicular germ cell tumor: A rare case report

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