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A 40-year-old woman presented with recurrent chest pain. Past medical history was positive for schizoaffective disorder, polysubstance abuse, and gestational diabetes mellitus. The physical examination was unremarkable. Results of an ECG and a test for cardiac enzymes, including troponins, were negative. Transthoracic echocardiography showed a well-circumscribed, smooth, homogeneous mass measuring up to 1.5 cm in the distal inferior vena cava (IVC) that was protruding into the right atrium (Figure 1A). Transesophageal echocardiography confirmed the mass and showed it to be arising from the distal IVC near the right hepatic vein entry (Figure 1B).Figure 1. A , Parasternal right ventricular inflow view of a transthoracic echocardiogram demonstrates a homogeneous echogenic mass that is extending into the right atrium from the inferior vena cava. B , Transgastric inferior vena cava long-axis view with transesophageal echocardiography demonstrates the mass (white arrow) prolapsing into the right atrium from the inferior vena cava. Note that the mass is contiguous with the liver tissue, and its echogenicity is identical to that of the liver.Magnetic resonance imaging showed …

Multimodality Imaging of an Unusual Case of an Obstructive Intracaval Mass by an Aberrant Liver