PMC2878669_01
Right atrial mass imaging by different modalities: (a) Transthoracic echocardiography, apical four-chamber view. Thickening of the right atrial wall (arrow). (b) Chest CT, axial view. Enhancing mass (arrow) with papillary projections in the lateral wall of the right atrium. (c) Cardiac MRI, axial view. A heterogeneous, vascular mass involving the right atrial lateral wall. (d) Intracardiac echocardiography. Irregular mass (arrow) infiltrating the right atrial wall.
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fig1
Transthoracic echocardiogram showed mild thickening of the right atrial wall (Figure 1(a)). The mass filled most of the RA appendage with an irregularly shaped border (Figure 1(b)). Siemens Medical Solutions, Malvern, PA) with gadolinium contrast showed a similar appearance of the mass without evidence of fat or any delayed enhancement (Figure 1(c)). She was referred to our institution for biopsy of the mass.  ICE showed papillary projections as seen on the CT scan (Figure 1(d)).
Cardiac MRI after chemotherapy of right atrial angiosarcoma showing significant resolution of the mass.
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She underwent 4 cycles of chemotherapy with doxorubicin and ifosfamide, and surveillance cardiac MRI showed significant resolution of the RA mass (Figure 2).