Multimodality imaging approach for the diagnosis of a left atrial mass

Abstract

Background: Cardiac masses may be incidentally found or in relation to the clinical presentation. Depending on the complexity of the lesion, a multimodality imaging approach may be necessary for a proper diagnosis.Case Report: We report the case of a 64-year-old male patient who was referred for pre-chemotherapy work-up of a metastatic scrotal melanoma. Echocardiography showed incidental heterogeneous left atrial mass. Further investigation using cardiovascular magnetic resonance imaging, computed tomography angiography, and positron emission tomography confirmed the findings that were consistent with a left atrial myxoma vascularized by a left circumflex coronary-cameral fistula.Conclusions: When the clinical context may be misleading, assessment of a cardiac mass with a multimodality approach is essential in order to define its exact benign or malignant nature.

Dumbbell in the atrium: A rare case report of biatrial myxoma that crosses atrial septum diagnosed by multimodal echocardiography

“…5,6 CEUS can be used to make differential diagnosis of thrombus and tumor by contrast agent perfusion in the mass, furthermore, to depict mass qualitatively as benigh or malignant. 7,8 Through TEE, RT-3D TEE, and CEUS, this case was correctly diagnosed, it demonstrates the importance of multimodality echocardiography in the diagnosis of atypical myxomas.…”

“…RT‐3D TEE offers incremental value in the evaluation of intracardiac masses (thrombi, tumors, and vegetations), by providing real‐time and post‐processing assessments of size, shape, inner composition, and relationships with surrounding structures, with 3D images like surgical view 5,6 . CEUS can be used to make differential diagnosis of thrombus and tumor by contrast agent perfusion in the mass, furthermore, to depict mass qualitatively as benigh or malignant 7,8 . Through TEE, RT‐3D TEE, and CEUS, this case was correctly diagnosed, it demonstrates the importance of multimodality echocardiography in the diagnosis of atypical myxomas.…”