PMC8077454_01
Echocardiographic image, 2D (left) and 3D (right). A tumor mass, suspected for myxoma is visible in the left atrium. Reproduced with kind permission from Prof. Mojca Bervar.
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F1
The transthoracic and transesophageal echocardiography discovered a massively enlarged left atrium, fibrous changes of the mitral valve and a mobile tumor formation measuring 2.8 x 3.6 cm that arose from the posterior annulus (shown in Fig. 1).
a The protruding pedunculated part of the left atrial malignant melanoma metastasis, situated above the mitral valve and growing into the interatrial septum. b Pleomorphic spindle cells with prominent nucleoli and high mitotic activity, arranged in random-oriented short fascicles. HE staining, x200. c Strong diffuse nuclear and cytoplasmic staining for S100 protein, x400. d Strong diffuse nuclear staining with PRAME, x400.
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F2
It did not overgrow the mitral valve (shown in Fig. 2a). A histopathological examination (shown in Fig. 2b-d) revealed a pleomorphic spindle-cell malignant tumor with high mitotic activity and focal necrosis.