An intracavitary right ventricular mass: a diagnostic dilemma-a case report

Document Type

Article

Publication Date

9-1-2026

Publication Title

Eur Heart J Case Rep

Abstract

BACKGROUND: Intracardiac masses are a diagnostic challenge in cardiology because thrombus and malignancy may demonstrate similar imaging features on initial evaluation.

CASE SUMMARY: An elderly male admitted for sepsis was incidentally found to have a right ventricular outflow tract mass initially presumed to be thrombus, and anticoagulation was initiated. Follow-up imaging demonstrated interval enlargement despite therapy, prompting further evaluation. Transesophageal echocardiography and cardiac magnetic resonance raised concern for malignancy, and biopsy confirmed poorly differentiated non-small cell lung carcinoma with cardiac metastasis. Given advanced disease and poor functional status, disease-directed therapy was deferred, and hospice care was pursued.

DISCUSSION: Cardiac metastases are more common than primary cardiac tumours and occur in up to 9%-14% of patients with metastatic cancer, with lung cancer representing the most frequent primary source. Prior literature emphasizes multimodal imaging when presumed thrombus fails to respond to anticoagulation.

CONCLUSION: Interval growth of an intracardiac mass despite anticoagulation should prompt diagnostic reassessment and advanced cardiac imaging.

PubMed ID

42756732

Volume

10

Issue

9

First Page

676

Last Page

676

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