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Bagai S, Malik V, Prasad P, Singh P, Sahu A, Khullar D. Poorly Differentiated Lung Cancer with Intracardiac Extension Causing Malignant Stroke in a Peritoneal Dialysis Patient: a Case Report. SN COMPREHENSIVE CLINICAL MEDICINE 2022; 4:255. [PMCID: PMC9662106 DOI: 10.1007/s42399-022-01331-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Sahil Bagai
- Department of Nephrology and Renal Transplant Medicine, Max Super Speciality Hospital, Saket, Delhi India
| | - Vipra Malik
- Department of Pathology, Core Diagnostics Pvt Ltd, Gurugram, India
| | - Pallavi Prasad
- Department of Nephrology and Renal Transplant Medicine, Max Super Speciality Hospital, Saket, Delhi India
| | - Priyanka Singh
- Department of Radion Oncology, Max Super Speciality Hospital, Saket, Delhi India
| | - Amit Sahu
- Department of Radiology, Max Super Speciality Hospital, Saket, Delhi India
| | - Dinesh Khullar
- Department of Nephrology and Renal Transplant Medicine, Max Super Speciality Hospital, Saket, Delhi India
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Allouch AH, Zaeiter HA, Harb RM, Dandach LI. Non-Small Cell Lung Cancer Presenting as a Mobile Left Atrial Mass. Cureus 2022; 14:e27859. [PMID: 36134062 PMCID: PMC9481220 DOI: 10.7759/cureus.27859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 12/02/2022] Open
Abstract
Primary cardiac tumors are extremely rare and mostly metastatic in origin. The signs and symptoms depend on the location of the tumor rather than its histopathology and, rarely, may be the first presentation of the malignant disease. We report a 54-year-old woman diagnosed with non-small lung cancer with new-onset heart murmur and dyspnea on exertion as the first clinical manifestations.
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Ma R, Wang GL, Liu JB, Cai L, Liu P, Tan XZ. Perioperative Cerebral Infarction Secondary to Pulmonary Vein Tumor Thrombus in a Patient with Lung Myxofibrosarcoma. Am J Respir Crit Care Med 2022; 205:959. [PMID: 34861137 PMCID: PMC9838621 DOI: 10.1164/rccm.202105-1300im] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Rong Ma
- Department of Radiology, Hunan Provincial People’s Hospital, First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China; and
| | - Gui-Liang Wang
- Department of Radiology, Hunan Provincial People’s Hospital, First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China; and
| | - Jian-Bin Liu
- Department of Radiology, Hunan Provincial People’s Hospital, First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China; and
| | - Li Cai
- Department of Neurology, the Third Hospital of Changsha, Changsha, Hunan, China
| | - Peng Liu
- Department of Radiology, Hunan Provincial People’s Hospital, First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China; and
| | - Xian-Zheng Tan
- Department of Radiology, Hunan Provincial People’s Hospital, First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China; and
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Cacciapuoti F, Vetrano E, Cacciapuoti F. Left atrial invasion of a lung cancer: a case report. Monaldi Arch Chest Dis 2021; 92. [PMID: 34865463 DOI: 10.4081/monaldi.2021.2098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/02/2021] [Indexed: 11/23/2022] Open
Abstract
Lung cancer is the leading neoplastic form worldwide for both incidence and mortality and represents the largest contributor to new cancer diagnosis. Cardiac extensions of a pulmonary neoplasm are rare and dramatically under-diagnosed because of the extreme variability of clinical presentation and frequently are expression of an advanced-stage primary lung cancer. The invasion often happens through pulmonary veins in absence of a clear respiratory impairment. Symptoms related to the cardiac involvement as the first presentation of a malignant pulmonary neoplasm are very uncommon and related with poor outcome. Here we present a case of invasion of the left atrium of a pulmonary neoplasm with initial cardiac manifestations and a laboratory finding of hypercalcemia.
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Affiliation(s)
| | - Erica Vetrano
- Post-graduate School of Internal Medicine "L. Vanvitelli" University, Naples.
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Liu J, Chen H, Xie X, Yang Y, Tang S. Lung tumor presenting with acute myocardial infarction and lower extremity arterial embolism. BMC Cardiovasc Disord 2020; 20:482. [PMID: 33176705 PMCID: PMC7659083 DOI: 10.1186/s12872-020-01770-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lung tumor embolization leading to acute myocardial infarction (AMI) is rare. Previouscases of lung tumor embolization were reported in the coronary artery. We describe here a case of lung tumor embolization leading to the simultaneous occurrence of AMI and lower extremity arterial embolism. CASE PRESENTATION A 64-year-old patient was admitted to the emergency department complaining of chest pain and was diagnosed with AMI.An echocardiography showed a mass in the left atrium that was speculated to be a myxoma. An emergency coronary angiography found no evidence of atherosclerosis. On the second day of admission, the patient was diagnosed with lower extremity arterial embolism. Initially, we speculated that the left atrium myxoma caused an embolism resulting in the AMI and lower extremity arterial embolism.However, a lung tumor was the real cause of both conditions. Unfortunately, the patient abandoned treatment when he learned of his disease and died three days later after being discharged from the hospital. CONCLUSIONS Lung tumor embolism is an extremely rare cause of AMI. Even rarer is the case presented here, in which a lung tumor embolism caused AMI and lower extremity arterial embolism. Clinicians should recognize lung tumor embolism as a potential cause of AMI.
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Affiliation(s)
- Jichun Liu
- Department of Cardiology, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, 241001, Anhui, People's Republic of China
| | - Hao Chen
- Department of Pathology, Wannan Medical College, Wuhu, 241002, Anhui, People's Republic of China
| | - Xiangrong Xie
- Department of Cardiology, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, 241001, Anhui, People's Republic of China
| | - Yuwen Yang
- Department of Cardiology, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, 241001, Anhui, People's Republic of China.
| | - Shengxing Tang
- Department of Cardiology, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, 241001, Anhui, People's Republic of China.
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Nosrati A, Nabati M, Vahedi L, Shokri M. Invasion of poorly differentiated large-cell neuroendocrine tumor of the lung through right pulmonary veins into the left atrium: A very rare case report. JOURNAL OF CLINICAL ULTRASOUND : JCU 2020; 48:560-564. [PMID: 33031570 DOI: 10.1002/jcu.22844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 04/02/2020] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
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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Affiliation(s)
- Anahita Nosrati
- Imam Khomaini Hospital, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Nabati
- Department of Cardiology, Faculty of Medicine, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Laleh Vahedi
- Imam Khomaini Hospital, Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mojtaba Shokri
- Fatemeh Zahra Hospital, Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Aldiwani H, Ahmed A, Kumar K, Shokr M, Cardozo S. Recurrent Stroke Due to Pulmonary Vein Thrombosis in a Patient with Metastatic Lung Adenocarcinoma. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e923554. [PMID: 32712617 PMCID: PMC7414828 DOI: 10.12659/ajcr.923554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Patient: Male, 64-year-old Final Diagnosis: Atrial fibrillation • lung cancer • stroke • thrombosis of the vein Symptoms: Confusion Medication: — Clinical Procedure: — Specialty: Cardiology
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Affiliation(s)
- Haider Aldiwani
- Department of Internal Medicine, Scripps Mercy Hospital Chula Vista, San Diego, CA, USA
| | - Abdelrahman Ahmed
- Department of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | - Kartik Kumar
- Department of Internal Medicine, Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA
| | - Mohamed Shokr
- Department of Internal Medicine, Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA
| | - Shaun Cardozo
- Department of Internal Medicine, Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, MI, USA
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Faiek S, Malik I, Farquhar R, Lal V, Bansal A. Pulmonary Vein Tumor Thrombus With Intracardiac Extension Secondary to Poorly Differentiated Bronchogenic Carcinoma. Cureus 2020; 12:e8278. [PMID: 32601554 PMCID: PMC7317124 DOI: 10.7759/cureus.8278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Pulmonary vein thrombosis (PVT) is a rarely encountered disease entity with varied clinical presentations. It has been reported to be associated with underlying lung malignancy in multiple case reports. Diagnosis can be challenging due to nonspecific symptoms on presentation. Herein, we report a 67-year-old male patient with a history of extensive smoking and chronic obstructive pulmonary disease (COPD) who presented with multiple hemoptysis episodes. CT scan of the chest with contrast showed multiple right lower lobe (RLL) lung masses and a thrombus in the inferior pulmonary vein. After various imaging modalities and transthoracic biopsy of the lung mass, the patient was diagnosed with pulmonary vein tumor thrombus secondary to poorly differentiated bronchogenic carcinoma with intracardiac extension. The patient was started on Eliquis for anticoagulation and is currently in the process of beginning chemo/radiation therapy for the underlying malignancy.
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Affiliation(s)
- Saif Faiek
- Internal Medicine, AtlantiCare Regional Medical Center, Atlantic City, USA
| | - Ishita Malik
- Internal Medicine, AtlantiCare Regional Medical Center, Atlantic City, USA
| | - Rhea Farquhar
- Internal Medicine, AtlantiCare Regional Medical Center, Atlantic City, USA
| | - Vikram Lal
- Internal Medicine, AtlantiCare Regional Medical Center, Atlantic City, USA
| | - Aditya Bansal
- Internal Medicine/Pulmonary & Critical Care Medicine, AtlantiCare Regional Medical Center, Atlantic City, USA
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Atrial invasion and showering phenomenon in primary lung cancer: A case report. Respir Med Case Rep 2020; 30:101064. [PMID: 32382497 PMCID: PMC7199007 DOI: 10.1016/j.rmcr.2020.101064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 04/21/2020] [Indexed: 12/25/2022] Open
Abstract
Advanced lung cancer can have numerous extra-pulmonary complications. Due to the proximity to the heart, cardiac invasion and the subsequent seeding of the tumor into the vascular system present numerous challenges in physician team care coordination. Here we have a 55-year-old male who presented with stroke symptoms in the setting of undiagnosed advanced lung cancer complicated by direct tumor invasion into the left atria and mixed embolic showering phenomenon and thrombotic hypercoagulability. Review of both the embolic showering phenomenon and hypercoagulability will be discussed as both can result in embolic occlusion or metastatic seeding at distant sites. Fewer than ten cases of spontaneous tumor embolization resulting from lung cancer invasion of the pulmonary vein have been reported. Poor prognosis of advanced lung cancer requires delicate, yet pragmatic conversations between care teams and the patient. Lung cancer has potential sequelae that extend well beyond confines of pulmonary pleura. Caution is needed when differentiating between tumor extension and metastatic seeding for atrial masses in the setting of lung cancer. The showering phenomenon of tumor emboli should be considered when presented with stroke symptoms that cannot be attributed to a unilateral deficit or when multiple areas of the brain are affected.
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