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Journal of Thoracic Oncology:
doi: 10.1097/JTO.0b013e31816927c5
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Left Atrial Mass

Cristea, Mihaela C. MD*; Venkataraman, Kalyanasundaram MD†

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Departments of Medical Oncology* and Cardiology,† City of Hope, Duarte, California.

Disclosure: The authors declare no conflict of interest.

Address for correspondence: Mihaela C. Cristea, MD, 1500 E Duarte Rd, Duarte, California. E-mail:

Copyright © 2008 by the International Association for the Study of Lung Cancer

A 48-year-old-man with a 3-month history of cough was involved in a motorcycle accident complicated by chest trauma and right ankle fracture. The CAT scan of the chest revealed a left-sided pneumothorax, a left hilar mass, mediastinal adenopathy, and renal masses. The transbronchial biopsy showed a poorly differentiated adenocarcinoma. A follow-up CAT scan revealed a rapidly progressing lung mass with obstruction of the entire left lung, and a thrombus versus mass in the left atrium. The 2D echocardiogram confirmed a 2.7-cm left atrial lesion. The transesophageal echocardiogram described a mass within the left atrium (LA), coming out of the pulmonary vein (Figure 1A). The appearance of the mass changed during systole and diastole (Figure 1A, 1B). This was consistent with an arm of the primary lung tumor extending into the left atrium and did not support the diagnosis of thrombus.1–3 The patient received one cycle of chemotherapy, but died shortly thereafter from progression of his lung cancer.

Figure 1
Figure 1
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In this case, the transesophageal echocardiogram clarified the etiology of the left atrial mass and prevented unnecessary anticoagulation.

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1. Daniel WG, Mugge A. Transesophageal echocardiography. N Engl J Med 1995;332:1268–1279.

2. Ragland MM, Tak T. The role of echocardiography in diagnosing space-occupying lesions of the heart. Clin Med Res 2006;4:22–32.

3. Reeder GS, Khandheria BK, Seward JB, et al. Transesophageal echocardiography and cardiac masses. Mayo Clin Proc 1991;66:1101–1109.


Atrial mass; Lung cancer; Transesophageal echocardiogram; Anticoagulation

© 2008International Association for the Study of Lung Cancer


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