Cardiac tamponade because of left atrium direct invasion by a large cell neuroendocrine metastatic carcinoma of the lung

A 53-year-old man presented with cardiac tamponade due to direct invasion of left atrium by a large cell neuroendocrine metastatic lung adenocarcinoma. Direct invasion of left atrial cavity by this type of lung tumour is rare. When cardiac involvement is suspected, two-dimensional echocardiography is the first-line diagnostic tool. Computerized tomography and magnetic resonance imaging can provide additional anatomical information and, as in this case, further delineation of the relation between intracavity masses and normal structures, including the mural site of attachment and tumour extension.