title: Endocardial Invasion of Lung Cancer Undiagnosable before Autopsy.
abstract: A 59-year-old male patient presented with left chest discomfort on admission. His medical history included encephalitis in childhood and his smoking history was 20 cigarettes per day for 40 years. A physical examination showed an anemic and edematous face with weak respiratory sounds in the left lung. The patient had elevated calcium levels and decreased hemoglobin and potassium. His parathyroid hormone-related protein level was elevated. Thoracic radiography showed cardiomegaly and computed tomography revealed a left lung mass with invasion of the heart and pleural effusion. Magnetic resonance imaging showed endocardial invasion of the tumor mass. Gallium-68 imaging revealed positive accumulation in the region surrounding the heart. No diagnoses were possible upon frequent cytology of his sputum and pleural effusion. The patient died from congestive heart failure with anoxia 38 days after admission. An autopsy revealed tumoral mass occlusion in the left main bronchus and tumoral invasion of the left atrium, left ventricle, and aorta.
authors.affiliation: Department of Community Medicine, Kanazawa Medical University, Uchinada, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Mizuno
authors.affiliation: Department of Geriatric Medicine, Himi Municipal Hospital, Kanazawa Medical University, Himi, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ishigami
authors.affiliation: Department of Community Medicine, Kanazawa Medical University, Uchinada, Japan ; Department of Respiratory Medicine, Himi Municipal Hospital, Kanazawa Medical University, Himi, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Community Medicine, Kanazawa Medical University, Uchinada, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Tsuchiya
authors.affiliation: Department of Community Medicine, Kanazawa Medical University, Uchinada, Japan.
authors.forename: C
authors.initials: C
authors.lastname: Nakajima
authors.affiliation: Department of Community Medicine, Kanazawa Medical University, Uchinada, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Sangen
authors.affiliation: Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Uchinada, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Fukushima
authors.affiliation: Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Uchinada, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Minato
authors.affiliation: Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Uchinada, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Nojima
authors.affiliation: Department of Nephrology, Himi Municipal Hospital, Kanazawa Medical University, Himi, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Saito
authors.affiliation: Department of Nephrology, Himi Municipal Hospital, Kanazawa Medical University, Himi, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Hayashi
authors.affiliation: Department of Endocrinology, Himi Municipal Hospital, Kanazawa Medical University, Himi, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Atsumi
authors.affiliation: Department of Endocrinology, Himi Municipal Hospital, Kanazawa Medical University, Himi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Respiratory Medicine, Himi Municipal Hospital, Kanazawa Medical University, Himi, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Iguchi
authors.affiliation: Department of Community Medicine, Kanazawa Medical University, Uchinada, Japan.
authors.forename: D
authors.initials: D
authors.lastname: Usuda
authors.affiliation: Department of Gastroenterology, Himi Municipal Hospital, Kanazawa Medical University, Himi, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Okamura
authors.affiliation: Department of Gastroenterology, Himi Municipal Hospital, Kanazawa Medical University, Himi, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Urashima
authors.affiliation: Department of Cardiology, Himi Municipal Hospital, Kanazawa Medical University, Himi, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Asano
authors.affiliation: Department of Cardiology, Himi Municipal Hospital, Kanazawa Medical University, Himi, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Kiyosawa
authors.affiliation: Department of Cardiology, Himi Municipal Hospital, Kanazawa Medical University, Himi, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Fukuda
authors.affiliation: Department of Cardiology, Himi Municipal Hospital, Kanazawa Medical University, Himi, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Takekoshi
authors.affiliation: Department of Community Medicine, Kanazawa Medical University, Uchinada, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kanda
keywords: Autopsy; Endocardium; Lung cancer; Parathyroid hormone-related protein
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