Primary lung tumour visualised by transthoracic echocardiography
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We present images of a rare case where a primary lung tumour was visualised by transthoracic echocardiography. The patient was a 78-year-old male where Chest X-ray had revealed a tumour-suspected structure in the left lung. Both transthoracic echocardiography and combined PET/CT images showed a large tumour located close to the heart. Fine-needle biopsy showed non-small cell lung cancer.
KeywordsPulmonary Vein Transthoracic Echocardiography Primary Lung Tumour Cardiac Metastasis Lung Cancer Metastasis
Echocardiography has a vital role for monitoring cardiac function. The field of view is, however, limited when it comes to a structure that has extracardiac location. It is well known that extracardiac structures such as hiatal hernias, pleural effusions or ascites can be evaluated with transthoracic echocardiography . We present images of a rare case where a primary lung tumour was visualised by transthoracic echocardiography.
The only reason that the primary lung tumour was visualised by transthoracic echocardiography was due to the close proximity to the heart and therefore in the field of view. It would be rather preposterous to suggest that transthoracic echocardiography could be a method for visualization of primary lung tumour. This case highlights, however, the importance of careful inspection of extracardiac space when performing transthoracic echocardiography. Most case reports of echocardiography and lung tumours are about various presentations of metastases, which may not be surprising since primary lung cancer is one of the most prevalent sources of cardiac metastases. Previous reports include lung cancer metastases that led to ECG alterations mimicking acute lateral or antero-lateral ST-elevation infarction [3, 4]. Also, invasive growth of lung cancer to the left atria through pulmonary vein has been described . Another echocardiography presentation of intra thoracic tumours has been compression pulmonary artery or pulmonary vein [6, 7]. Combined PET/CT images are becoming the method of choice for staging of primary non-small cell cancer . Use of a radiopharmaceutical such as FDG provides the information of tumour metabolism, whereas CT images give anatomical information. The principal use has been for primary staging and because of the high negative predictive value reducing the number of mediastinoscopys.
Written informed consent was obtained from the patient for publication of this case report.
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