We present a 37-year-old man with history of incompletely treated testicular germ cell tumor presenting with persistent cough. Computed tomography(CT) demonstrated a large pulmonary mass invading the mediastinal vasculature, bronchi, and thrombus in the pulmonary vein extending into the left atrium. Biopsy of the lung mass confirmed germ cell tumor. Transthoracic echocardiography revealed a mass in the left atrium, consistent with a tumor or thrombus. Systemic chemotherapy was started with cisplatin and etoposide with curative intent.