Giant right atrial mass obliterating the right atrium

While hematogenous spread of renal cell carcinoma (RCC) is common, isolated extension into the renal vein and inferior vena cava (IVC) is rare and extension to the right atrium is even less likely. In the case, a 62-year-old Hispanic female was admitted for a suspected inferior myocardial infarction, and her echocardiogram revealed a right atrial mass consistent with the appearance of an atrial myxoma. Following cardiac catheterization, a histopathological examination of the mass revealed a clear cell tumor consistent with metastatic clear cell RCC. Following a CABG with excision of the atrial mas, the CT demonstrated a 5 cm right lower pole renal mass with hilar involvement, as well as filling defects in the IVC extending into the right renal vein; these findings were consistent with RCC tumor thrombus extension into the renal vein, IVC, and right atrium. The radical nephrectomy necessary for tumor removal could not be performed at this hospital, so the patient was discharged to a higher level of care. The incidence rate for RCC with extension into the right atrium is quite low, but clinicians should understand the lethality of RCC warrants immediate clinical investigation upon diagnosis. The increased utilization of sophisticated imaging modalities will likely continue to increase the rate of incidental discovery of such neoplasms, and physicians should keep RCC on the differential when a right atrial mass is discovered incidentally on echocardiogram.

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Right Atrial Metastatic Melanoma with Unknown Primaries

Case Reports in Cardiology ◽

10.1155/2015/483520 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3

Author(s):

Robin Kuriakose ◽

Rakhi Melvani ◽

Venkataramanan Gangadharan ◽

Michael Cowley

Keyword(s):

Metastatic Melanoma ◽

Right Atrium ◽

Vena Cava ◽

Right Atrial ◽

Reduced Ejection Fraction ◽

Atrial Mass ◽

Right Atrial Mass ◽

History Of ◽

The Right ◽

And Function

A 54-year-old male with history of anemia and rheumatoid arthritis presented with a three-month history of dyspnea on exertion and lower extremity edema. Patient was referred for a transthoracic echocardiogram that revealed a large right atrial mass with reduced ejection fraction of 40% and an incidental large liver mass. Subsequent cardiac MRI revealed a lobulated right atrial mass measuring 5.4 cm×5.3 cm with inferior vena cava compression and adjacent multiple large liver lesions confirmed to be malignant melanoma through biopsy. Interestingly, no primaries were found in the patient. PET/CT imaging displayed hypermetabolic masses within the right atrium and liver that likely represent metastases, as well as bilateral pleural effusions, most likely due to heart failure. Preoperative coronary angiogram demonstrated perfusion to the mass by a dense network of neovasculature arising from the mid right coronary artery. The cardiac melanoma was surgically removed, and the right atrium was reconstructed with a pericardial patch. After surgery, all cardiac chambers appeared normal in size and function with associated moderate tricuspid regurgitation. The patient is currently being administered ipilimumab for systemic therapy of metastatic melanoma.

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Renal Cell Carcinoma presenting as a Right Atrial Mass

Journal of Perioperative Echocardiography ◽

10.5005/jp-journals-10034-1024 ◽

2014 ◽

Vol 2 (2) ◽

pp. 65-67

Author(s):

Arun Subramanian ◽

Minati Choudhary ◽

Ujjwal Chowdhary

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Right Atrium ◽

Renal Cell ◽

Inferior Vena ◽

Vena Cava ◽

Right Atrial ◽

Atrial Mass ◽

Right Atrial Mass ◽

The Right

ABSTRACT Renal cell carcinoma (RCC) has a tendency to invade the renal vein and thereby reach the right heart through inferior vena cava (IVC). This may necessitate a combined surgical procedure usually under cardiopulmonary bypass (CPB). In the following discussion, we shall present a case of right RCC extending into the right atrium. The patient underwent a radical nephrectomy followed by removal of the tumor from right atrium, IVC and hepatic vein under CPB. How to cite this article Subramanian A, Choudhary M, Chowdhary U. Renal Cell Carcinoma presenting as a Right Atrial Mass. J Perioper Echocardiogr 2014;2(2):65-67

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Cardiac Lipoma: An Uncharacteristically Large Intra-Atrial Mass Causing Symptoms

Case Reports in Cardiology ◽

10.1155/2018/3531982 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Fahad Syed Naseerullah ◽

Hemangkumar Javaiya ◽

Avinash Murthy

Keyword(s):

Right Atrial ◽

Rare Type ◽

Atrial Mass ◽

Persistent Symptoms ◽

Coronary Syndrome ◽

Cardiac Tumours ◽

Large Size ◽

Right Atrial Mass ◽

Cardiac Lipoma ◽

The Right

Primary tumours of the heart are often encountered in clinical practice. Different autopsy series estimate the incidence to be anywhere from 0.001% to 0.19%. Cardiac lipoma is a rare type of tumour of the heart and pericardium. It comprises approximately 10–19% of all cardiac tumours. We present a case of a large cardiac lipoma in a fifty-year-old female. She presented with sharp chest pains, palpitations, and dizziness. Acute coronary syndrome was ruled out. A transthoracic echocardiogram showed an abnormal, large, fixed right atrial mass. The mass was noted to be occupying most of the right atrium. It was excised due to its large size and persistent symptoms. On pathophysiology, the mass was definitively diagnosed to be an 80 mm × 70 mm cardiac lipoma. Postoperatively, the patient did well with resolution of her symptoms. This case provides evidence that even large, invasive, symptomatic cardiac lipomas can be successfully resected with good outcomes.

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Ping-Pong Ball, Tumor or Thrombus in the Right Atrium? A Case Report

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135118767328 ◽

2018 ◽

Vol 9 (3) ◽

pp. 350-351

Author(s):

Stephanie Ghaleb ◽

Bryant Roosevelt ◽

James Cnota

Keyword(s):

Clinical Judgment ◽

Right Atrium ◽

Frozen Section ◽

Noninvasive Imaging ◽

Neoadjuvant Treatment ◽

Lower Lobe ◽

Final Diagnosis ◽

Right Atrial ◽

Right Atrial Mass ◽

The Right

Tumors and thrombi are the most common cardiac masses of the right atrium. The use of noninvasive imaging to differentiate between the two can be deceiving, and the clinical judgment of a cardiologist and the emergency of the situation should be partnered to decide on the next step of the management. We present the case of a 29-year-old lady who was receiving neoadjuvant treatment for her rhabdomyosarcoma and was incidentally found to have a very large, very mobile right atrial mass that was protruding in the right ventricle with each cardiac cycle along with findings of a small segmental right lower lobe pulmonary embolism. Along with noninvasive imaging, frozen section analysis procured the wrong diagnosis, and the mass was ultimately found to be a right atrial thrombus on definite pathology review. Exact management of right atrial masses continues to be not well delineated, and when in doubt, final diagnosis might need to be “a posteriori” and based on the treatment response.

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Metastatic Colorectal Carcinoma to the Right Atrium: A Case Report and Review of Literature

10.21203/rs.3.rs-138793/v1 ◽

2021 ◽

Author(s):

Humaira Sarfraz ◽

Abeer Arain ◽

Mukul K. Divatia ◽

Mary R. Schwartz ◽

Kirk E. Heyne

Keyword(s):

Colorectal Cancer ◽

Next Generation Sequencing ◽

Metastatic Colorectal Cancer ◽

Clinical Management ◽

Right Atrial ◽

Next Generation ◽

Atrial Mass ◽

Right Atrial Mass ◽

The Right ◽

Generation Sequencing

Abstract Background: Cardiac metastasis due to colon cancer is extraordinarily uncommon. Given the rarity of diagnosis, there is paucity of evidence and hence, no established guidelines for evaluation or clinical management strategy. Clinical presentation: We present the case of a 59 year old male with a previously treated colonic carcinoma who presented with new onset exertional dyspnea. He was noted to be having a right atrial mass on an echocardiogram performed at his cardiologist’s office. Further workup with CT angiogram of the chest confirmed a right atrial mass measuring 4.0 cm. Serum CEA was normal. Biopsies of the right atrial mass demonstrated metastatic moderately differentiated colonic adenocarcinoma. Mismatch repair protein expression analysis by immunohistochemistry showed no loss of MLH1, MSH2, MSH6 or PMS2 expression. Next generation sequencing for RAS and BRAF mutations was negative. Patient received treatment with FOLFIRINOX/ bevacizumab with noted reduction in size of mass. Conclusion: To the best of our knowledge, this is the first report of next generation sequencing results available on a biopsy of metastatic colorectal cancer to the heart with the largest literature review of 31 reported cases of metastatic colorectal cancer to the heart. It will help direct clinical management and also adds evidence to the potential efficacy of treatment of this rare aggressive disease with chemotherapy in combination with VEGF inhibitors.

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A Case Report: Mixed Thrombus Formation in a Previously Sutured Right Atrium

The Heart Surgery Forum ◽

10.1532/hsf98.2013287 ◽

2014 ◽

Vol 17 (4) ◽

pp. 234 ◽

Cited By ~ 1

Author(s):

Ling Yunfei ◽

Li Dongxu ◽

Luo Shuhua ◽

Wang Yabo ◽

Deep San ◽

...

Keyword(s):

Case Report ◽

Right Atrium ◽

Mixed Type ◽

Septal Defect ◽

Thrombus Formation ◽

Anterior Wall ◽

Right Atrial ◽

Pathologic Examination ◽

Right Atrial Mass ◽

The Right

We describe the case of a 19-year-old Chinese woman who nine months prior underwent repair of an atrial septal defect and came to our hospital with a right atrial mass attached to the anterior wall of the right atrium on transthoracic echocardiography. Pathologic examination revealed the mass was a mixed-type thrombosis with some unusual organization, which previously was not described in literature.

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Acute heart failure from a rapidly progressing large tumor in the right atrium

10.22514/sv.2021.095 ◽

2021 ◽

Keyword(s):

Heart Failure ◽

Medical History ◽

Right Atrium ◽

Right Atrial ◽

Emergency Physicians ◽

Large Tumor ◽

Intracardiac Mass ◽

Chief Complaints ◽

Right Atrial Mass ◽

The Right

The diagnosis and treatment of intracardiac mass are challenging for emergency physicians. Dyspnea is one of the most common chief complaints in ER among patients with rapidly progressed heart failure without significant medical history. Establishing such an unusual diagnosis based on dyspnea patients requires more evidence. We present a case of a patient who was diagnosed with a rapidly progressing right atrial mass.

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