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Corresponding author at: The University of Texas Medical School at Houston, 6431 Fannin St. MSB 2.130B, Houston, TX 77030, United States. Tel.: +1 713 704 1786; fax: +1 713 704 1596.
A 50 year-old male with a 60 pack-year smoking history presented with worsening left
upper back pain. He also complained of increasing shortness of breath, difficulty
in swallowing, and unintentional 40-pound weight loss over the past four months. Chest
computed tomography revealed a large left lower lobe mass (asterisk in Fig. 1A) and numerous soft tissue nodules along the pericardium (arrows in Fig. 1A and B). Echocardiogram also revealed echogenic pericardial nodules (Fig. 1C). Findings were most suggestive of primary bronchogenic malignancy with pericardial
metastases. Subsequent biopsy of the left lower lobe mass revealed invasive squamous
cell carcinoma. Abdominal magnetic resonance imaging done later for other reasons
also demonstrated the enhancing nodules along the pericardium (Fig. 1D).
Fig. 1Nodular pericardial metastases from primary bronchogenic malignancy. (A and B) Contrast-enhanced
computed tomography with axial (A) and sagittal reformation (B) reveals numerous soft
tissue nodules, compatible with metastases, along the pericardium (arrows). Asterisk
in (A) denotes the primary bronchogenic malignancy. (C) Apical transthoracic echocardiogram
demonstrates echogenic pericardial nodules (arrows). D. Contrast-enhanced magnetic
resonance imaging also shows the bulky enhancing pericardial nodules (arrows).
