Atypical Intracavitary Cardiac Mass: Tumor or Thrombus?

Cardiac masses are a rare finding, with most masses found being thrombi or vegetations. Still, some masses are suspected to be a tumor based on multiple characteristics such as size, location, mobility, and the tumor's hemodynamic effects. Cardiovascular magnetic resonance (CMR) and CT have been shown to differentiate a tumor from a thrombus based on tissue characteristics of the mass. Here we highlight the role of contrast perfusion imaging on echocardiography in identifying the malignant potential of a cardiac mass. This case report demonstrates the effectiveness of contrast imaging with a transesophageal echocardiogram in identifying the etiology of cardiac masses without the need of CMR or cardiac CT, which helps save between $100-1207 of hospital costs. Besides the cost-benefit, the use of non-invasive and easily accessible imaging like echocardiogram enables smaller facilities with limited resources to diagnose and hence further manage patients with cardiac masses.