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• W2766705568 abstract "SESSION TITLE: Non-Small Cell Lung Cancer SESSION TYPE: Affiliate Case Report Poster PRESENTED ON: Tuesday, October 31, 2017 at 01:30 PM - 02:30 PM INTRODUCTION: Lung cancer is the leading cause of cancer related death worldwide. It is metastatic in a significant percentage of patients at diagnosis. Common sites of metastasis include adrenals, brain, bone and liver. Uncommon sites include intestine, skin, heart and thyroid. We present a rare case of lung cancer with metastasis to heart and thyroid. CASE PRESENTATION: A 67 year old female presented with cough and hemoptysis for 3 weeks. Computerized tomography (CT) scan of the chest showed right sided lung mass with mediastinal lymphadenopathy. Positron emission tomography (PET-CT) scan showed increased uptake in these lesions, with no other activity outside the chest. Endobronchial ultrasound and biopsy confirmed the diagnosis of squamous cell lung cancer-stage IIIB (T2bN3M0), and she was started on chemotherapy. PET-CT done 2 months after treatment showed improvement in size of lung lesion and mediastinal lymph nodes, but new lesions were identified in the thoracic spine and ribs. Palliative radiotherapy was started in additional to chemotherapy. A PET-CT repeated after 3 months showed progression of disease with enlarging spine lesions and new lesion in the right lobe of thyroid. Thyroid lesion was biopsied and the histological findings were similar to the prior lung biopsy sample. Patient started having hemoptysis again and presented to emergency room. CT chest revealed multiple metastatic lesions in liver, large pericardial effusion and a mass involving the left ventricular lateral wall measuring up to 4.3 cm. Echocardiogram confirmed large pericardial effusion and a large extra-cardiac mass attached to the lateral wall of left ventricle. Given her prognosis and poor response to treatment, she opted for hospice care. DISCUSSION: More than one thirds of patients with lung cancer have spread at the time of diagnosis. Common sites of metastasis from lung cancer include adrenals, brain, bone and liver. Rarely lung cancer can metastasize to intestines, skin, heart and thyroid. Very few cases of cardiac metastasis from lung cancer are reported. Most cases are diagnosed on autopsy. About two thirds of all cardiac metastases involve the pericardium, one third the epicardium or myocardium and rarely the endocardium. Of all the cardiac metastasis, it is adenocarcinoma in 26%, squamous cell carcinoma in 23.4%, undifferentiated in 21.2%, and bronchoalveolar carcinoma in 17.4% of cases(1). Thyroid metastasis from primary lung cancer is an even rarer thing. Common cancers which metastasize to thyroid include colon and kidneys. On extensive literature review, we could find very few cases of lung metastases to thyroid. Our patient had unfortunately two unusual metastatic sites of lung cancer. CONCLUSIONS: Lung cancer can rarely metastasize to locations like heart and thyroid, and we report the only case in literature with combined cardiac and thyroid metastasis. Reference #1: Bussani R, De-Giorgio F, Abbate A, Silvestri F. Cardiac metastases. J Clin Pathol 2007;60:27-34. DISCLOSURE: The following authors have nothing to disclose: Jay Patel, Shejuti Guha, Vishesh Paul No Product/Research Disclosure Information" @default.
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• W2766705568 date "2017-10-01" @default.
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• W2766705568 title "An Unusual Case of Cardiac and Thyroid Metastasis From Lung Cancer" @default.
• W2766705568 doi "https://doi.org/10.1016/j.chest.2017.08.715" @default.
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