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Despite the considerable mortality and morbidity in metastasis cardiac mass,antemortem diagnosis is unusual.Here we report a case of a left atrial mass echocardingraphically mimicking myxoma,in a patient with lung carcinoma.The mass was pathologically confirmed to be metastatic carcinoma,which had entered the left atrium via direct invasion of left superior pulmonary vein,illustrating the potential for unusual routes of tumor spread into the heart and the importance of obtaining a tissue diagnosis in such cases.