Brain magnetic resonance imaging (MRI) was performed

for staging of lung cancer. On the brain MRI, there was no evidence of metastatic lesion. However on diffusion weighted image, high signal intensity spots, which show low signal intensity at apparent diffusion coefficient map were noted in both parietal cortex. This finding suggested acute embolic infarction. Fig. 1 Chest X-ray and selleck bio computed tomography findings of lung lesion. Soft tissue fullness at right infra-hilar area and air-fluid level in right lower lung field (A). Cavitary lung mass with inner low density and multilocular effusion in the right lower lobe … To evaluate the cardiac origin of embolic infarction, transthoracic Inhibitors,research,lifescience,medical echocardiography (TTE) Inhibitors,research,lifescience,medical was performed. TTE showed normal sized cardiac chambers with normal LV systolic function, and there were no pericardial effusion or outside compressing mass. However 2.4 × 1.4 cm sized hyper-mobile, multi-lobulated, cystic mass was observed

at the LV outflow track (LVOT). The mass had connection with the basal portion of the interventricular septum (IVS) by narrow Inhibitors,research,lifescience,medical stalk. Although the mass was protruded to the LV lumen, there was no significant flow obstruction in LVOT (Fig. 2). Fig. 2 Transthoracic echocardiography findings of left ventricular mass in parasternal long axis (A) and apical 4 chamber view (B). Hyper-mobile, 2.4 cm × 1.4 cm sized mass is attached at interventricular septum of left ventricular outflow tract (white … To differentiate the character of LVOT mass, PET-CT was performed. On PET-CT, hyper-metabolic mass [maximal standardized uptake value (SUVmax) = 14.8]

with central necrosis was observed at right lower lobe and multiple FDG uptaking lymph-nodes were observed in the right hilum and subcarinal mediastinum. Intense FDG uptaking Inhibitors,research,lifescience,medical mass (2.5 Inhibitors,research,lifescience,medical × 2.3 cm) was also noted at IVS of LV (SUVmax = 13.9) suggesting metastasis of lung cancer (Fig. 3). Fig. 3 18-fludeoxyglucose (FDG) positron emission tomography-computed tomography image of left ventricular mass and lung mass. The low density lesion in interventricular septum (A: black arrow) showed intense FDG uptake [B: white arrow, maximal standardized … She didn’t have any cardiac symptoms related to LV mass and there was no neurologic symptom associated with embolic infarction, and her lung Drug_discovery cancer stage was IV, we made decision not to operate her cardiac lesion. She received one cycle of chemotherapy for metastatic lung adenocarcinoma and discharged. However, she couldn’t receive another cycle of chemotherapy due to poor general condition, and expired due to respiratory failure after two months. Discussion The heart is frequently the site of metastasis of various malignant tumors and metastatic tumors are 20 to 40 times more common than primary tumors.6) The most common neoplasm associated with cardiac metastasis are lung cancer, lymphoma, breast cancer, leukemia, stomach cancer and melanoma.