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Case Reports
. 2017 Jan 15;103(2):153.
doi: 10.1136/heartjnl-2016-310301. Epub 2016 Sep 12.

An unusual finding in the right atrium

Chee Loong Chow  1   2 , Sylvia S M Chen  1 , William van Gaal  1   2
Affiliations
Case Reports

An unusual finding in the right atrium

Chee Loong Chow et al. Heart. .

Abstract

Clinical introduction: A 66-year-old asymptomatic patient underwent a routine transthoracic echocardiogram prior to commencement of clozapine, and was found to have a mobile echogenic structure in the right atrium, which was later confirmed on transoesophageal echocardiogram to be adjacent to the insertion of inferior vena cava.Follow-up cardiovascular MRI (CMR) revealed a mobile, avascular 2.1×2.2 cm2 mass with regular and smooth borders, adjacent to the eustachian valve (Figure 1 panel A: coronal view; online supplementary movie 1). Late gadolinium enhancement (LGE; panel B) demonstrated heterogeneity, and T1-imaging demonstrated mild hyperintensity (panel C). There was no evidence of obstructive haemodynamic compromise.The mass was subsequently resected, and the histology (H&E staining, magnification ×100) is shown in panel D.

Question: The diagnosis of this mass is: Aberrant liverAngiosarcomaAtrial myxomaRenal cell carcinomaThrombus.

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