1 Department of Medicine, Reading Hospital, Reading, PA 19611, USA.
2 Department of Cardiology, Reading Hospital, Reading, PA 19611, USA.
*Corresponding Author: Rebecca DeBoer
Department of Medicine, Reading Hospital, Reading, PA 19611, USA.
Email: [email protected]
Received : Jan 20, 2022
Accepted : Mar 02, 2022
Published : Mar 09, 2022
Archived : www.jcimcr.org
Copyright : © DeBoer R (2022).
With the rise in screening modalities, incidental findings increase. We present a case of a computed tomography (CT) chest lung cancer screen that resulted in the diagnosis of a right ventricular (RV) myxoma. Echocardiogram and cardiac magnetic resonance imaging (CMR) led to this diagnosis.
A 57-year-old Caucasian male with a 60-pack year history presented to his primary care provider for an annual exam. CT chest revealed a faint calcification in the RV apex (Figure 1A). In subsequent transthoracic echocardiogram, attached to the RV apex free wall was a 2.4 cm X 1.5 cm heterogeneous mass with central calcification suggestive of RV myxoma (Figure 1B). Cardiac magnetic resonance imaging (CMR) showed minimal rim enhancement of a 2.1 X 2.5 X 1.3 cm centrally calcified mass arising from the free wall of the RV apex consistent with myxoma (Figure 1C and 1D). The patient remained asymptomatic with a normal cardiac exam.
Cardiac tumors remain rare . They can be divided into primary or secondary . Most primary tumors are myxomas found in the atria . Only a small portion originates in the right ventricle . Estimated to be 8% in one review . Most patients will be symptomatic . One study found only 13% of patients were asymptomatic .
Echocardiography has long been utilized and cardiac magnetic resonance imaging (CMR) has become a more optimal form of imaging cardiac tumors . Due to the improved resolution of CMR, this imaging modality can lead to definitive diagnoses of cardiac masses . CMR can reliably indicate the extent of tumor and attachment to the cardiac wall . CMR can also characterize the anatomy and tissue features, which can differentiate from other masses such as malignant tumors and cardiac thrombi .