Intracardiac Extension of a Pulmonary Pleomorphic Carcinoma

Pleomorphic carcinoma is an extremely rare histological type of lung malignancy. Although it carries an aggressive clinical course, intracardiac extension has never been reported before. We describe a 53-year-old lady presented to our emergency department with progressive shortness of breath and intermittent fever for six weeks. After detailed work-up, a lung tumor with intracardiac extension via pulmonary vein to the left atrium was disclosed. Pathologic examination of a computerized tomography-guided lung biopsy showed pleomorphic carcinoma. The patient underwent wide excision of the left atrial tumor and subsequent right pneumonectomy smoothly. Both the left atrial and lung tumors showed the same histologic picture of pleomorphic carcinoma. However, brain metastasis was disclosed three months after operation. The patient eventually died of severe sepsis six months later.