Cardiac dynamic magnetic resonance of a giant lung carcinoma invading the left atrium: do not let the imaging fool you.

This study aimed to report on a non-small-cell lung cancer (NSCLC) originating from the right lung lower lobe and circulatory extension into the left atrium. Atrial involvement is an uncommon feature of advanced NSCLC, occurring in up to 10% of patients with bronchogenic carcinoma. In this case, the neoplastic mass was enormous and diagnosed as a lung pleiomorph carcinoma, staged T4N2M0 and so far considered irresectable. Conventional static imaging (chest CT-positron emission tomography scan; cardiac MRI) failed to rule out any direct invasion into surrounding structures. Surgery is the gold standard treatment for the local control of NSCLC without distant metastasis. Finally, preoperative cardiac dynamic magnetic resonance imaging and transoesophageal echocardiography were crucial to assess resectability, showing the absence of tumour invasion inside the pulmonary circulation and in the left atrium, supporting the decision-making for a radical, curative, surgical resection.