PMC3232555_01
(A) Prenatal echocardiogram at 31st week showing a right atrial non-homogenous non-mobile mass approximately 19.5X18.8mm. (B) Prenatal echocardiogram at 34th week showing the right atrial mass approximately 23.5X24.9mm and moderate sized pericardial effusion. (LA= left atrium, LV= left ventricle, PE= pericardial effusion, RV = right ventricle).
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F1
The tumor was based predominantly on the free wall of the right atrium and showed dramatic growth between the 29th and 31st week of gestation, with an increase in size from 12 by 13mm to 19.5 by 18.8mm (Fig. 1A). This rapid phase of growth then plateaued with the tumor reaching 23.5mm by 24.9mm in diameter by the 34th week (Fig. 1B).
Operative view (A) Tumor (T) adherent to free wall of right atrium. (B) Tumor being separated from right atrium.
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F2
A right atriotomy was made and the tumor was noted to be densely adherent to the free wall of the right atrium (Fig. 2A & 2B) extending down toward the IVC and then curving back upwards onto the underside of the AV groove.
(A) H&E stain showing vascular channels with myxoid stroma in between (original magnification x100) (B) Ulex stains the blood vessels demonstrating the vascular nature of the lesion (original magnification x100)
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F3
Histopathological exam revealed a vascular lesion, composed of a mixture of small, slit like vessels and solid areas (Fig. 3A). Ulex staining demonstrated the vascular nature of the lesion (Fig. 3B).