Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Transoesophageal echocardiography and the intraoperative diagnosis of left atrial invasion by carcinoid tumour

Abstract

A 41-yr-old woman with pulmonary carcinoid tumour presented for thoracotomy and lung resection. However, intraoperative transoesophageal echocardiography (TEE) revealed that the tumour had invaded the left atrium, and the planned resection was aborted to allow resection under cardiopulmonary byass at a later date. Although the incidence of cardiac involvement by lung cancer at the lime of pulmonary resection is unknown, transoesophageal echocardiography can be useful in identifying the extension of hilar lung tumours. This should preferentially be done preoperatively, but can be done intraoperatively as described in this case report.

Résumé

Une patiente de 41 ans souffrant d’une tumeur cardinoïde pulmonaire se présente pour thoracotomie et résection pulmonaire. Toutefois, l’échocardiographie transoesophagienne peropératoire montre que la tumeur envahit l’oreillette gauche et la résection programmée est retardée pour permettre d’effectuer la résection sous circulation extracorporelle à une date ultérieure. Bien que l’incidence de l’atteinte cardiaque au moment d’une résection pulmonaire soit inconnue, l’échocardiographie transoesophagienne peut devenir utile pour identifier l’extension hilaire des tumeurs pulmonaires. Elle est préférable avant l’intervention, mais on peut la réaliser pendant l’opération, comme c’est le cas ici.

References

  1. 1

    Clements F. The evolution of anesthesiologistechocardiographer.In: Bruijn NP, Clements FM (Eds.). Intraoperative Use of Echocardiography. Philadelphia, PA: J.B. Lippincott Company, 1991: 1–12.

  2. 2

    Seward JB. Cardiac tumours and thrombus: transesophageal echocardiographic experience.In: Erbel R, Khanlheria B, Brenecke R, Meyer J, Seward JB, Tajik AJ (Eds.). Transoesophageal Echocardiography. New York, NY: Springer-Verlag, 1989, 120–8.

  3. 3

    Narang J, Neuslein S, Israel D. The role of transesophageal echocardiography in the diagnosis and excision of a tumour of the aortic valve. J Cardiothorac Vasc Anesth 1992; 6: 68–9.

  4. 4

    Alam M, Sun I, Smith S. Transesophageal echocardiographic evaluation of right atrial mass lesions. J Am Soc Echocardiogr 1991; 4: 323–30.

  5. 5

    Strauss BL, Mathews MJ, Cohen MH, Simon R, Tejada F. Cardiac métastases in lung cancer. Chest 1977; 71: 607–11.

  6. 6

    Darby C, Sinclair M, Westaby S. Treatment of a malignant bronchial carcinoid affecting the mediastinum and left atrium by radical two stage resection with cardiopulmonary bypass and somatostatin infusion. Br Heart J 1990; 63: 55–7.

Download references

Author information

Correspondence to Steven M. Neustein.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Neustein, S.M., Cohen, E., Reich, D. et al. Transoesophageal echocardiography and the intraoperative diagnosis of left atrial invasion by carcinoid tumour. Can J Anaesth 40, 664–666 (1993). https://doi.org/10.1007/BF03009703

Download citation

Key words

  • measurement techniques: echocardiography
  • surgery: cardiovascular, thoracic