Case of cystic and solid mass in right atrium

A 56-year-old male visited the clinic because of chest tightness and shortness of breath after exertion for 6 months. Physical examination revealed body temperature 36.3°C, pulse 76 beats/min, 20 breaths/min, and blood pressure 135/80 mmHg. Preoperative transthoracic echocardiography showed an irregular medium echo mass in the right atrium (Panel A). The size was about 42 × 26 mm; it swung along with the cardiac cycle, with a pedicle attached to the roof of the right atrium. The transesophageal echocardiography showed a cystic mass with intact envelope attached to the orifice of the inferior vena cava in the right atrium (Panel B; Video 1). Contrast perfusion imaging showed no perfusion within the mass (Panel C and D; Videos 2 and 3). Computerized tomography results revealed a heterogeneous high-density lesion at the orifice of the inferior vena cava in the right atrium (Panel E). No abnormal enhancement was observed (Panel F). The magnetic resonance imaging result showed a round-like short T2 signal near the inferior vena cava (Panel G and H). No obvious enhancement was noted.