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A giant left atrial mass—Clinical treatment dilemma
Author(s) -
Hsi David H.,
Ebright Michael I.,
Del Prete Salvatore A.,
Pearson Gregory,
Bernstein Michael A.
Publication year - 2019
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14367
Subject(s) - medicine , radiology , superior vena cava , warfarin , thrombus , magnetic resonance imaging , lesion , atrial fibrillation , cardiology , surgery
A 74‐year‐old female current 75 pack‐year smoker presented with shortness of breath and mild hemoptysis. Chest computed tomography showed a large right upper lobe mass compressing the superior vena cava, invading the right pulmonary veins, and occupying the majority of the left atrium. Brain magnetic resonance imaging revealed a 13 mm right parietal lesion with surrounding edema consistent with metastasis. A 3 D TEE showed a large mobile mass in the left atrium. Bronchoscopy confirmed that the tumor mass was consistent with a moderately to poorly differentiated squamous cell carcinoma. She underwent chemotherapy, radiation, and immune therapy. She was also started on warfarin for anticoagulation after the initial chemotherapy with resolution of the left atrial mass. We feel that the patient most likely had carcinogenic thrombus in the pulmonary veins and left atrium.