Supplementary Material for: Endocavitary right ventricular cardiac metastasis of a lung adenocarcinoma treated by surgery : a novel multimodal therapeutic approach

Cardiac metastasis (CM) is a rare lung cancer location. It often remain clinically silent but may cause life threatening complications. Better survival rate thanks to the immunotherapy revolution and the improving performance of imaging lead to an increasing number of CM diagnosis. We report a case of a fifty-four-years old woman who was diagnosed with a stage IIIa non-small cells lung cancer. She developed a right ventricular cardiac metastasis during treatment by immunotherapy after concurrent chemoradiotherapy. Cardiac magnetic resonance imaging concluded to an endocavitary tissular lesion at the RV apex. A surgical complete resection consisting of a right ventriculotomy was performed. Thanks to immunotherapy and more performing imaging, similar cases are more frequent. Our case report also highlights the fact that CM surgery has to be considered as a successful therapeutic option in those oligo-progression situations. Guidelines on the management and treatment of lung cancer CM are needed as well as larger studies to evaluate the benefit from a surgical treatment on the survival rate.