Obstruction of right ventricular outflow tract by extended cardiac metastasis from esophageal cancer Ho-Joong Youn, MD, Seung Eun Jung, MD, Wook Sung.

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Obstruction of right ventricular outflow tract by extended cardiac metastasis from esophageal cancer Ho-Joong Youn, MD, Seung Eun Jung, MD, Wook Sung Chung, MD, Myung Gyu Choi, MD, Kyo Young Lee, MD, Kyu Won Chung, MD, Soon Jo Hong, MD, Hee Sik Sun, MD Journal of the American Society of Echocardiography Volume 15, Issue 12, Pages 1541-1544 (December 2002) DOI: 10.1067/mje.2002.128119 Copyright © 2002 American Society of Echocardiography Terms and Conditions

Fig. 1 A, Esophagogram shows irregular margined-filling defect of distal esophagus from T7 level to esophagogastric junction, suggesting esophageal cancer. B, Endoscopy shows ulcerative encircling mass of distal esophagus, about 10 cm in length, suggesting esophageal cancer. C, Endoscopic biopsy from esophagus shows characteristic features of squamous cell carcinoma (hematoxylin and eosin stain, ×100). Journal of the American Society of Echocardiography 2002 15, 1541-1544DOI: (10.1067/mje.2002.128119) Copyright © 2002 American Society of Echocardiography Terms and Conditions

Fig. 2 A, Parasternal short-axis view obtained by 2-dimensional echocardiography. Echocardiogram shows large mass in right ventricular outflow tract. B, Color Doppler echocardiogram. High-velocity turbulent flow indicates obstruction in right ventricular outflow tract. C, Color Doppler echocardiogram shows feeding vessel in middle of tumor (arrow). D, Pulsed Doppler echocardiogram shows diastolic dominant flow. M, tumor mass; Ao, aorta. Journal of the American Society of Echocardiography 2002 15, 1541-1544DOI: (10.1067/mje.2002.128119) Copyright © 2002 American Society of Echocardiography Terms and Conditions

Fig. 3 A, T2-weighted coronal image shows large lobulated mass with intermediate signal intensity in right ventricular outflow track (RVOT) (arrowhead) and at base of right ventricle (RV). RVOT is severely stenosed. Mass is closely abutted in pericardium. Pericardial thickening is associated. B, T2-weighted coronal image shows thickened esophageal wall (arrows), suggesting esophageal carcinoma. M, tumor mass; Ao, aorta. Journal of the American Society of Echocardiography 2002 15, 1541-1544DOI: (10.1067/mje.2002.128119) Copyright © 2002 American Society of Echocardiography Terms and Conditions

Fig. 4 A, Coronary angiogram of right coronary artery shows small and tortuous vessels originating from conus branch of right coronary artery (arrow), suggesting neovascular formation at site corresponding to right ventricular outflow track (RVOT). B, Lateral view of right ventriculography shows large mass occupying RVOT (arrows). C, Endomyocardial biopsy from right ventricle (RV) shows invasion of squamous cell carcinoma (hematoxylin and eosin stain, ×100). MPA, main pulmonary artery. Journal of the American Society of Echocardiography 2002 15, 1541-1544DOI: (10.1067/mje.2002.128119) Copyright © 2002 American Society of Echocardiography Terms and Conditions