A bumpy road to the diagnosis of metastatic lung cancer

Cardiac tumors pose the uncommon group of disorders and most of them are metastases. They are generally localized in the left heart and may present with non-specific symptoms. Diagnosis may be often difficult due to the presence other heart diseases. The gold standard in diagnosing is non-invasive imaging. We present a case of a 77-year-old male admitted to our hospital due to flu symptoms, headaches and loss of weight in the last 2–3 weeks. The diagnostic process including computed tomography (CT) and magnetic resonance imaging revealed pathological contrast enhancement in the left parietal lobe, whereas subsequent transthoracic echocardiography disclosed a pathological oval mass 2.5 x 3.5 cm in the left heart suspected of a metastasis. Results of echocardiography turned the diagnostic process around and extended to bronchoscopy and abdominal CT. Finally, central left lung tumor with metastases to lungs, pleura, lymphoid nodes of the right hilar, left ventricle, left suprarenal gland and central nervous system was diagnosed.