Metastatic obliterating mass of right ventricular cavity: A report of case and echocardiographic features.

We present the case of a 63-year-old man with a history of non-small cell lung carcinoma (NSCLC) and systemic chemotherapy who suffered from progressive shortness of breath and peripheral edema. Transthoracic echocardiography showed a huge non-homogenous mass nearly completely filling the dilated right ventricle. The border of mass was not differentiable from the right ventricular myocardium. The findings of echocardiographic study were highly suggestive for cardiac metastasis. Computed tomography and positron emission computed tomography confirmed the presumed diagnosis. Lung cancer is one of the most common primary tumors of cardiac metastasis and NSCLC accounts for about 85% of all lung cancers. Lymphatic spread or direct invasion usually involves the pericardium or epicardium. However, metastasis to the myocardium and endocardium is extremely rare. The huge size, location, direct invasion to myocardium and echocardiographic features of this cardiac mass have made it a unique case for presentation. <Learning objective: Despite the versatility and high accuracy of cardiac computed tomography (CT), magnetic resonance imaging, and 18-fluorodeoxyglucose positron emission CT, echocardiography remains the modality of choice for the initial evaluation and follow-up examinations of cardiac masses. Although echocardiography is limited in regard to tissue characterization and characterization of extra cardiac structures, this image modality is widely accessible without relevant side effects, and allows the assessment of hemodynamic consequences of cardiac masses involving the myocardium valves, or pericardium.>.