Phantom tumor of the lung in a patient with preserved left ventricular systolic function

Abstract

A 69-year-old male patient chronic smoker with a past history of hypertension, myocardial infarction was admitted with complaints orthopnea. Examina­tion revealed a blood pressure of 150/100 mmHg, pulse 114/min, tachypnea, jugular venous disten­tion. Extensive bilateral crackles over both lung fields. The findings were consistent with the diagno­sis of acute pulmonary edema. Chest radiography and tomography revealed a spherical mass in the middle lobe of the right lung, obscuring the right side of the cardiac silhouette (Fig. 1). Echocardiographic evaluation showed preserved left ventricular systol­ic function with ejection fraction of 60%, and signs of restrictive type of diastolic dysfunction (E/A=4.8, DT 100 msec). An increase in diuretic dose result­ed in improvement in the patient\'s symptoms and A repeat radiograph and tomography (Fig. 2) after successful treatment of the acute pulmonary edema showed complete resolution of the opacity consis­tent with the diagnosis of “pseudotumor” or “vanish­ing tumor” or “phantom tumor” of the lung. Phantom tumor is generally believed to occur in patients with systolic dysfunction (1). Phantom tumor of the lung refers to the accumulation of fluid in the interlobar spaces as a result of congestive heart failure, giving the radiological appearance of a neoplasm. Rapid radiological improvement in response to treatment for heart failure is a classical feature of this clini­cal entity. Although phantom tumor is generally be­lieved to occur in patients with systolic dysfunctio, in our case, its appearance was secondary to diastolic dysfunction. We presented phantom tumor of the lung in a patient with preserved left ventricular sys­tolic function. J Clin Exp Invest 2013; 4 (2): 242-243