PMC4008244_01
(a) Chest CT; (b) Tumor in RA displayed sternotomy (c) extensive necrosis and hemorrhage of the tumor to manipulation; (d) peroperative transesophageal echocardiogram, showing compression of RA, resolved after resection of the tumor (e) RA: right atrium; RV: right ventricle.
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fig1
During hospitalization, the patient developed massive right hemothorax, diagnosed by Computed Tomography (CT) scan without contrast, as shown in Figure 1(a), where we can also see the heart tumor. The mass was located in the pericardium covering the access to vena cava and great vessels (Figure 1(b)). The highly vascularized mass with necrotic material was adhered to the anterior wall of RA, extending SVC, aorta, and right ventricle (RV) (Figure 1(c)). The peroperative transesophageal echocardiogram showed hemodynamic compromise caused by compression of RA with resolution after resection (Figures 1(d) and 1(e)).
(a) Proliferation of spindle cells forming vascular channels with prominent endothelial cells, (b) vascular neoplasm with solid areas, suffused with red blood cells and endothelial cells with hyperchromatic nuclei.
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fig2
Histopathology showed spongy tissue with spindle cell proliferation forming irregular vascular channels as well as varying degrees of endothelial pleomorphism and presence of mitoses and extensive areas of hemorrhage (Figures 2(a) and 2(b)).