Transthoracic echocardiography: apical four-chamber view; presence of a large, nonhomogeneous mass infiltrating the diaphragmatic wall occupying the most of the apical right ventricular cavity can be observed. Its shape was multilobulated and its margins were defined. The entire whole myocardial apex showed an increase in echogenicity. Thin arrows: the right apical ventricle cavity is almost completely obliterated; mass involving right ventricular wall; thick arrow: mass involving the cardiac apex. ra, right atrium; la, left atrium; lv, left ventricle; details in the text.