PMC1766349_01
MRI heart. A. Sagittal. B. Coronal. RA = Right atrium, LA = Left atrium, LV = Left ventricle, SVC = Superior vena cava. The close proximity of the tumor to the right atrium and extension towards a thickened interatrial septum can be seen.
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F1
The mass showed heterogenous very mild enhancement (Figure 1A).
Intra-operative picture depicting extra-cardiac tumor (arrow). Inset A, Resected specimen. Inset B, Immunohistochemistry showing strong diffuse positivity for S-100.
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F2
At surgery, a solid rubbery 8 cm x 8 cm mass was found outside the heart within the pericardium on the lateral wall of the right atrium, and extending to the right superior pulmonary vein (Figure 2). The mass was resected en-bloc externally, close to the interatrial septum (Figure 2A). A definitive diagnosis of an atrial schwannoma was made due to the strong diffuse uniform staining for s100beta typical for atrial schwannoma and the characteristic immunohistochemical appearance. (Figure 2B).