PMC3890009_01
a Transversal angiography CT image after intravenous iodised contrast fluid without ECG triggering shows an inhomogeneous enhancing mass in the right atrium that protrudes through the tricuspid valve towards the right ventricle. Pericardial and bilateral pleural effusion is also seen. b Coronal angiography CT image. There is retrograde flow of contrast fluid towards the liver veins and inferior caval vein; signs of right-sided failure of the heart are present
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Fig1
CT of neck and thorax revealed a large inhomogeneously enhancing mass within the right cardiac atrium measuring 7.5 x 6.5 cm (Fig. 1).
a Transversal T1 weighted black-blood ECG-triggered image before the infusion of gadolinium shows a relatively high signal intensity of a mass in the right atrium, compared with that of the muscles. Artefacts can be seen due to the large amount of pleural fluid. b Transversal T1 weighted SE echo planar imaging (EPI) ECG-triggered image after gadolinium shows strong enhancing of the mass in the right atrium, highly suspicious for atrial metastasis of the melanoma. There is a large amount of pleural effusion
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Fig2
T1 weighted black-blood images and after the injection of gadolinium contrast agent, the intra-atrial mass showed inhomogeneous enhancement. There was a large amount of pleural effusion but no residual pericardial effusion (Fig. 2) The MRI image was highly suggestive for intracardial metastasis of the melanoma due to melanotic signal intensity on T1-weigthed images. 