Intracardiac Metastasis From Testicular Teratoma

Emanuel and Lloyd (1962) have recently re-emphasized the close similarity between the clinical picture of right atrial myxoma and that of constrictive pericarditis.In the case presented here this same clinical picture was produced acutely by a metastasis from a testicular teratoma within the cavities of the right atrium and ventricle.Case Report A man aged 36 had a left orchidectomy for teratoma in November 1960, and was referred to the Radio- therapy Department of Westminster Hospital on December 8, 1960.Between that date and January 19, 1961, he was given radiotherapy to the abdomen.Thereafter he remained in good health until June 1961, when he developed pleuritic pain in the front of the left side of the chest and, later, similar pains in the right axilla and both scapular regions.There was slight hiemoptysis at this time and he was very dyspnceic at the onset of the pain but this rapidly subsided.Chest radiograph showed no significant abnormality.In October 1961, he once again noticed dyspncea on exertion which gradually increased in severity.There was no abnormality on physical examination.Chest radiograph showed a small right pleural effusion.There were also a few tiny opacities in both lung fields but tomography of the whole chest showed no evidence of metastases nor of hilar gland enlargement.Hogben and Friedman tests were negative.By the end of January, chest radiograph showed that the pleural effusion had resolved but there had been a small increase in heart size with prominence of the right atrium and superior vena cava.On February 11, 1962, he was admitted complaining of an acute onset of very severe dyspncea while walking briskly one week previously.He had become cyanosed and had almost lost consciousness.Since