A Case of Giant Negative T-wave Inversion due to RV Apical Hypertrophy Secondary to Metastatic Lung Cancer

摘要

We report a case of 63 year old man with giant negative T-wave inversion associated with metastic lung cancer to apex of right ventricle. On admission, chest x-ray demonstration a round and well marginated mass on right upper lobe. Electrocardiogram showed deep and symmetric T-wave inversion in precordial leads. This finding of electrocardiogram were compatible with apical hypertrophic cardiomyopathy. Under the impression of apical hypertrophic cardiomyopathy or acute coronary insufficiency, we performed 2D-echocardiogram. 2D-echocardiogram showed, about 6x3cm sized, inhomogeneous right ventricular apical mass. For the differential diagnosis of myocardiac infarction, we performed coronary angioram, Which showed no significant stenosis of right and left coronary artery. We performed a biopsy from lung mass and right ventricular apical mass. Pathologic examination revealed non-small cell lung cancer with metastasis to right ventricle. So we report a case of giant negative T-wave inversion suspected due to RV apical hypertrophic secondary to metastatic lung cancer with a review of literature.