Lung Cancer with Intracardiac Invasion Simulating Sick Sinus Syndrome

Cardiac metastases is more common than primer cardiac malign neoplasms. Cardiac metastases in bronchogenic carcinoma may occur due to retrograd lymphatic spread by hematogenous dissemination of tumour cells and direct invasion. Usually pericardium is involved in direct cardiac invasion by lung cancer, and pericardial effusion, pericarditis and tamponad occurs. Metastasis to the myocardium and endocardium of the right atrium (RA) is extremely rare. We report here on a 65 –year-old man initially presenting with attack of bradycardia-tachycardia and a cardiac syncope attack was admitted to the hospital. Two-dimensional echocardiography (EKO) revealed heart mass in right atrium. Computed tomography (CT) demonstrated a large tumor involving epicardium, myocardium in the right atrium. He was diagnosed with squamous cell carcinoma by bronchoscopy. We present this patient because of a rare case of lung cancer with myocardial invasion presenting with sick sinus syndrome.