A 28-year-old woman presented with a 3-week history of progressively worsening shortness of breath, orthopnoea and peripheral oedema. She was previously diagnosed with metastatic pulmonary sarcoma, necessitating right middle-lower lobectomy. She was distressed, hypoxic and hypotensive, with bilateral pitting oedema and a raised jugular venous pressure. A transthoracic echocardiogram revealed a sizable cavitated echogenic mass compressing the left ventricle (Fig. 1a and b). Contrast-enhanced chest computed tomography confirmed the presence of a large, fusiform-shaped, soft tissue mass compressing the left ventricle and causing rightward deviation of the heart (Fig. 2). Histology following resection confirmed the presence of a relapsed pulmonary sarcoma.
Fig. 1
a and b Transthoracic apical three-chamber view showing a large cavitated echogenic mass (arrow) compressing the left ventricle: LA left atrium, LV left ventricle
Fig. 2
Contrast chest computed tomography showing a sizable pulmonary sarcoma (arrow) causing rightward displacement of the heart: RA right atrium, RV right ventricle, LV left ventricle
