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European Journal of Echocardiography Advance Access published online on December 9, 2008

European Journal of Echocardiography, doi:10.1093/ejechocard/jen310
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Contrast-enhanced right atrial mass: tumour or thrombus?

Anna Corazon M. Calleja, Mohsen S. Alharthi, Bijoy K. Khandheria and Hari P. Chaliki*

Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, 13400 E. Shea Boulevard, Scottsdale, AZ 85259, USA

Received 3 November 2008; accepted after revision 10 November 2008.

* Corresponding author. Tel: +1 480 301 8375; fax: +1 480 301 8018. E-mail address: chaliki.hari{at}mayo.edu


   Abstract

We present a case of a 61-year-old female diagnosed with soft-tissue fibrosarcoma of the shoulder with a right atrial mass on transthoracic echocardiogram. To further assess the mass, contrast transoesophageal echo was performed. The mass was highly considered to be a thrombus due to the presence of multiple risk factors: atrial fibrillation, catheter use, and pulmonary embolism. However, a metastatic fibrosarcoma could not be excluded, given its enhancement with echo contrast. Finally, it was proved to be a thrombus with its rapid resolution while on anticoagulation. Therefore, it should be noted that in rare circumstances, thrombus may show enhancement with echo contrast and one needs to integrate all of the patient information to arrive at the correct diagnosis.

Keywords: Contrast echocardiography; Right atrium; Fibrosarcoma


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