PMC9513130_01
Echocardiogram pre-operatively showing a mass (red arrow) located in the in the right ventricular outflow tract (RVOT) in transthoracic four chamber cross section (A), transthoracic short axis section of aorta (B), transesophageal short axis section of aorta (C). Preoperative cardiac Computed Tomography (CT) showed a mass (red arrow) in the RVOT in transverse view (D), sagittal view (E); CT angiography (CTA) showed a filling defect (red arrow) in the right ventricular outflow tract (F). RV, right ventricle; LV, left ventricle; RA, right atrium; LA, left atrium.
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F1
However, a hyperechoic space occupying mass with clear boundary (approximately 36 x 30 mm in size) was found in the right ventricle near the outflow tract (Figures 1A-C). Computed tomography angiography (CTA) also showed that the right atrium and right ventricle were enlarged, and a round filling defect of about 3.5*4.2*2.2 cm was seen in the right ventricular outflow tract (Figures 1D-F).
A tumor was found in the anterior wall of the right ventricle (A). The specimen is a pale-yellow pedunculated ball with a texture close to myocardial tissue, and the cut surface with the "fish flesh" like texture (B). Low magnification of the hematoxylin-eosin (HE) stained section showed numerous blood vessels formed (blue star) against a background of fibrous tissue (C). At high magnification, mucus components (blue arrow) (D), fibrous components (blue box) (E) and formed blood vessels (blue star) (F) were observed.
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A right ventricular outflow tract incision was made, and a pedunculated tumor was found in the anterior wall of the right ventricle, with a diameter of about 3.5*2.5 cm (Figure 2A). The specimen was a pale-yellow pedunculated ball with a texture close to myocardial tissue, and the cut surface had a "fish-meat" like texture (Figure 2B). Low magnification of Hematoxylin-Eosin (HE) stained section shows numerous formed blood vessels against a background of fibrous tissue (Figure 2C). At high magnification, fibrous components, formed blood vessels, and mucus components were also observed (Figures 2D-F).
Seven-year postoperative echocardiography in transthoracic aortic short-axis views (A), right ventricular outflow tract view (B) and four chamber cross section view (C). The tumor did not recur and the right ventricular outflow tract was not obstructed. Right ventricular outflow tract, RVOT; RV, right ventricle; LV, left ventricle; RA, right atrium; LA, left atrium.
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After 7 years of follow-up, no tumor recurrence was found on echocardiography (Figure 3 and Supplementary materials).