Stenosis of Right Ventricular Outflow Tract by Myocardial Metastasis Developing after Resection of Lung Cancer

A rare case of myocardial metastasis of lung cancer inducing stenosis of the right ventricular outflow tract, detected by echocardiography, is presented. A 64-year-old man was admitted to our hospital with complaints of cough and emaciation in August 1990. Chest X-ray film and CT revealed a large mass in the left upper lung field. We performed left upper lobectomy with lymph node dissection, and the pathological diagnosis was poorly differentiated adenocarcinoma without lymph node metastasis. The postoperative course was uneventful until two weeks after operation, when exertional dyspnea developed progressively, and eventually a cardiac murmur became audible. Echocardiography disclosed a mass shadow protruding from the interventricular myocardium to the right ventricular outflow tract, almost occluding the orifice of the pulmonary artery. He died of heart failure on day 46 postoperatively, and postmortem examination disclosed myocardial metastasis of the lung cancer.