CTICasesIntraventricular Metastasis from Liposarcoma with LV Outflow Tract Obstruction
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Imaging findings
Chest CT demonstrated multiple bilateral pulmonary nodules with a hematogenous distribution, consistent with known liposarcoma metastases. A large interventricular mass was impressively seen, appearing to arise from the lateral wall of the left ventricle and extending into the left ventricular outflow tract (LVOT). Echocardiography confirmed that this mass was freely prolapsing into the LVOT, causing a dynamic obstruction. Further studies (not shown) reportedly showed macroscopic tumor emboli in the pulmonary arteries.
Key takeaways
This case illustrates a dramatic and unusual presentation of metastatic disease to the heart, specifically an intraventricular metastasis from liposarcoma, causing significant symptoms due to left ventricular outflow tract obstruction. While most systemic metastases are typically filtered by the lungs, seeding in the left ventricle can occur. This highlights that although rare, cardiac metastases can have severe functional consequences.
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