Endocavitary Right Ventricular Cardiac Metastasis of a Lung Adenocarcinoma Treated by Surgery: A Case Report About a Novel Multimodal Therapeutic Approach.

Introduction: Cardiac metastasis (CM) is a rare lung cancer location. It often remains clinically silent but may cause life-threatening complications. Better survival rates thanks to the immunotherapy revolution and the improving performance of imaging lead to an increasing number of CM diagnosis. Case Presentation: We report a case of a 54-year-old woman who was diagnosed with a stage IIIa non-small cell lung cancer. She developed a right ventricular CM without symptoms during treatment by immunotherapy after concurrent chemoradiotherapy. Cardiac magnetic resonance imaging confirmed the presence of an endocavitary lesion in the right ventricle apex. Complete surgical resection through a right ventriculotomy was performed. Conclusion: The diagnosis of similar cases has become more frequent due to immunotherapy and more advanced imaging technology. Our case report also highlights the fact that CM surgery has to be considered as a successful therapeutic option in those oligo-progression situations. Guidelines on the management and treatment of lung cancer CM are needed as well as larger studies to evaluate the survival benefit from surgical treatment.