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March 10, 1989

Echocardiographic Detection of Left Atrial Extension of Bronchial Carcinoma

JAMA. 1989;261(10):1478-1480. doi:10.1001/jama.1989.03420100114034

IT IS well known from autopsy series that metastatic tumors of the heart can be found in 1.5% to 20.6% (average, 6%) of patients with malignancies.1 The most common cause of metastatic heart disease is bronchial carcinoma, followed by carcinoma of the breast, malignant melanoma, lymphoma, and leukemia, in decreasing order of frequency.1 However, cardiac invasion is infrequently diagnosed ante mortem due to the lack of specific clinical manifestations.2

Atrial extension has been reported as a common route of local spread in patients with bronchial carcinoma.3,4 The echocardiographic features of such extension have been illustrated in only two cases,5,6 to our knowledge. The purpose of this report is to describe three patients with bronchial carcinoma in whom left atrial extension of the tumor was diagnosed by two-dimensional echocardiography.


Case 1.—  An 80-year-old man had a history of long-standing murmur consistent with aortic