Presentation
Vague chest pain.
Patient Data
Triple lead cardiac pacemaker with the leads intact. Sternotomy wires and mediastinal clips in keeping with prior CABG. Mild cardiomegaly.
Large round pulmonary opacity behind the cardiac pacemaker generator, localized to the anterior left upper lobe on the lateral projection.
Case Discussion
The patient underwent staging CT of the chest, abdomen and pelvis which revealed a non-obstructive hepatic flexure tumor and a solitary left upper lobe pulmonary mass abutting the anterior costal pleura. Colonoscopy and biopsy confirmed colonic adenocarcinoma. The patient declined treatment and was lost to follow up, hence the pulmonary mass is suspected (and not confirmed) as a metastasis.