Pancoast Tumor With Cardiac Metastases and Intracardiac Thrombosis.

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Citation: Journal of Investigative Medicine High Impact Case Reports. 11:23247096231154642, 2023 Jan-Dec.PMID: 36772879Institution: MedStar Union Memorial HospitalDepartment: Hospitalist | Internal Medicine ResidencyForm of publication: Journal ArticleMedline article type(s): Case Reports | Journal ArticleSubject headings: *Adenocarcinoma of Lung | *Heart Neoplasms | *Lung Neoplasms | *Pancoast Syndrome | *Thrombosis | Female | Heart Neoplasms/sc [Secondary] | Humans | Pancoast Syndrome/pa [Pathology]Year: 2023ISSN:
  • 2324-7096
Name of journal: Journal of investigative medicine high impact case reportsAbstract: Pancoast tumor is a rare and aggressive form of lung cancer; cardiac metastasis is very uncommon. We present a case of advanced Pancoast tumor, with extensive cardiac metastases and intracardiac thrombosis in a woman presenting with dyspnea, shoulder pain, and weight loss. A contrast-enhanced chest computed tomographic scan revealed an apical mass, metastatic thoracic nodes, and filling defects within both ventricles. Further imaging with cardiac magnetic resonance imaging revealed 2 left ventricular masses infiltrating into the myocardium suggestive of metastatic disease, and a multilobulated mass within the right ventricle suggestive of intracardiac thrombus. She was initiated on anticoagulation for intracardiac thrombosis. Surgical pathology of biopsied tissue samples was consistent with advanced metastatic lung adenocarcinoma. She was a poor candidate for surgical intervention. Given the patient's goals of care, she was ultimately transitioned to comfort care.All authors: Rao SJ, Iqbal SB, Sagheer UFiscal year: FY2023Digital Object Identifier: ORCID: Date added to catalog: 2023-04-11
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Pancoast tumor is a rare and aggressive form of lung cancer; cardiac metastasis is very uncommon. We present a case of advanced Pancoast tumor, with extensive cardiac metastases and intracardiac thrombosis in a woman presenting with dyspnea, shoulder pain, and weight loss. A contrast-enhanced chest computed tomographic scan revealed an apical mass, metastatic thoracic nodes, and filling defects within both ventricles. Further imaging with cardiac magnetic resonance imaging revealed 2 left ventricular masses infiltrating into the myocardium suggestive of metastatic disease, and a multilobulated mass within the right ventricle suggestive of intracardiac thrombus. She was initiated on anticoagulation for intracardiac thrombosis. Surgical pathology of biopsied tissue samples was consistent with advanced metastatic lung adenocarcinoma. She was a poor candidate for surgical intervention. Given the patient's goals of care, she was ultimately transitioned to comfort care.

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