Aberrant non-neoplastic liver tissue presenting as an intra-atrial mass

Description

A Caucasian woman aged 66 years underwent transthoracic echocardiography prior to initiation of clozapine treatment for schizophrenia. Echocardiography demonstrated a mobile 25x20x15 mm mass arising from the posterior right atrial wall adjacent to the Eustachian valve. There was no obstruction of the inferior vena cava (IVC), coronary sinus or tricuspid valve. Routine haematology and biochemistry, including liver function and cardiac enzymes, were within normal limits. Physical examination and ECG were unremarkable. Sine sequence cardiac MRI confirmed a low signal mobile right atrial mass (diameter 21x22 mm), appearances and tissue characterisation of which were suggestive of a benign atrial myxoma (figure 1A). The MRI suggested the mobile mass was attached to the Eustachian valve by a thin stalk. Intraoperative transoesophageal echocardiography revealed a non-calcified homogenous broad-based mass adjacent to the IVC–right atrium junction (figure 2A). Right atriotomy confirmed the lesion originated from the middle hepatic vein/IVC junction....

http://ift.tt/2nS8iex