CTICasesLeft Atrial Metastasis with Tumor Thrombus from Testicular Germ Cell Tumor
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Imaging findings
Initial radiographs show a subtle opacity inferior to the right hilum and a retrocardiac mass. CT subsequently reveals a large subcarinal mass invading the right inferior pulmonary vein and extending into the left atrium as tumor thrombus. The patient had a history of testicular germ cell tumor. Follow-up imaging after chemotherapy showed calcification within the left atrial mass, representing residual, calcified tumor thrombus.
Key takeaways
Testicular germ cell tumors can metastasize to the heart, with direct extension into cardiac chambers via pulmonary veins presenting as tumor thrombus. Chemotherapy can lead to significant regression and even calcification of residual tumor thrombus within the heart, avoiding the need for surgical resection in some cases. Cardiac metastases can present with subtle initial radiographic findings.
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