Clinical Images  |   November 2019
Extracardiac Lung Adenocarcinoma
Author Notes
  • From the Department of Cardiovascular Medicine at Ascension Macomb-Oakland Hospital in Warren, Michigan. 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  * Address correspondence to Faiza Choudhry, DO, Department of Cardiovascular Medicine, Ascension Macomb-Oakland Hospital, 11800 E Twelve Mile Rd, Warren, MI 48093-3472. Email:
Article Information
Imaging / Pulmonary Disorders / Clinical Images
Clinical Images   |   November 2019
Extracardiac Lung Adenocarcinoma
The Journal of the American Osteopathic Association, November 2019, Vol. 119, 772. doi:
The Journal of the American Osteopathic Association, November 2019, Vol. 119, 772. doi:
A 67-year-old man presented with dyspnea and hemoptysis for 2 days. His medical history included atrial fibrillation, anemia, chronic kidney disease, hypertension, and tobacco and alcohol dependence. Evaluation revealed atrial fibrillation with a rapid ventricular rate and absent breath sounds on the left lung. Computed tomography (CT) demonstrated left pleural effusion with complete atelectasis, opacification of the lung bronchi, and left-to-right mediastinal shift (image A). Echocardiography revealed a 7.8-cm hyperechoic extracardiac mass moving synchronously with the heart. Underfilling of the left ventricle was due to compression of the lateral and inferior ventricular walls (image B, video). Pathologic findings supported a diagnosis of primary metastatic adenocarcinoma of the lung. Pleural effusions and airway patency were managed with a catheter and radiation. Symptoms improved with palliative paclitaxel and carboplatin. 

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