Surgical Resection of a Large Right Ventricular Metastasis From Non–Small Cell Lung Cancer

BACKGROUND: Intracavitary right ventricular metastasis is a rare presentation of non-small cell lung cancer (NSCLC), often associated with dismal prognosis given associated complications such as tumor embolism, valve dysfunction, and right ventricular outflow tract obstruction. CASE SUMMARY: A 59-year-old man presenting with palpitations and tachycardia was found to have concomitant intracavitary right ventricular mass and lung mass. Ventricular mass was resected on cardiopulmonary bypass along with wedge resection of lung lesion, providing symptomatic relief and tissue diagnosis of pleomorphic NSCLC. The patient went on to receive systemic therapy (first immunotherapy, then targeted therapy) achieving 14-month overall survival. DISCUSSION: This case highlights a rare presentation of NSCLC with intracavitary cardiac metastasis and options for multimodal surgical and medical management. TAKE-HOME MESSAGES: Intracavitary right ventricular metastasis from NSCLC is rare and associated with poor prognosis. Surgical resection may be necessary to prevent fatal complications, such as right ventricular outflow tract obstruction.