An uncommon cause of right heart failure: primary cardiac pre-B cell acute lymphoblastic leukemia (RCD code: VI-2C.1).

Hematological malignancies are protean in their presentations. Primary cardiac tumors are exceedingly rare, and primary cardiac leukemia presenting as an isolated mass is even rare. Here, we present a case of a young man who presented with one month history of fever and shortness of breath. His examination revealed signs of right sided heart failure. On workup he was found to have a mass in the heart on CT scan of the chest, his transthoracic echocardiography showed an isolated right atrioventricular groove mass. Surgical biopsy confirmed it to be an extremely rare presentation of Pre B Acute Lymphoblastic leukemia(ALL). Though the patient underwent surgical excision of the lesion yet, he developed bone marrow leukemic involvement confirmed by bone marrow biopsy and died of overwhelming sepsis secondary to pancytopenia. This case highlights that hematological malignancies can present as cardiac masses and should be considered during workup of patients presenting with chronic fever and right sided heart failure.