Key result
Surgical excision of a massive right atrial mass in a 33-year-old woman with chronic myelogenous leukaemia revealed an old blood clot with extensive fibrin and focal necrosis, without malignant cells.
Why the study?
Right atrial masses are rare, their clinical course is not well documented, and diagnosis and management remain challenging without histopathological specimens.
Case Report (n=1)
This case highlights that intracardiac thrombus should be considered in the differential diagnosis of right atrial masses in patients with chronic myelogenous leukaemia, and multimodality imaging with a multidisciplinary approach is crucial for management.
Answers are grounded in this paper and cite their sources.
Thrombus merits consideration in the differential for right atrial masses in CML; this case report leaves open the role of multimodality imaging.
Right atrial masses are rare and diagnosis can be difficult unless histopathological specimens are obtained. In addition, the clinical course is not well documented, thereby making diagnosis and management challenging. The mass can be associated with haemodynamic instability with the potential to cause obstructive shock and embolism. We present the case of a young woman with untreated chronic myelogenous leukaemia with a massive haemodynamically significant right atrial mass. The usefulness of multimodality imaging and a multidisciplinary approach for diagnosing and treating this condition is highlighted. LEARNING POINTS: Right atrial mass is rare and can lead to pulmonary embolism and haemodynamic instability.As chronic myelogenous leukaemia is associated with an increased risk of thromboembolism, thrombus should be considered in the differential diagnosis of intracardiac masses.Multimodality imaging is indicated to guide diagnosis and appropriate management; in case of diagnostic uncertainty, histopathology may be needed to obtain a definitive diagnosis.
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Benjanuwattra et al. (2022) conducted a case report in Chronic myelogenous leukaemia with right atrial mass (n=1). Surgical excision was evaluated on Pathological diagnosis of the resected mass. Surgical excision of a massive right atrial mass in a 33-year-old woman with chronic myelogenous leukaemia revealed an old blood clot with extensive fibrin and focal necrosis, without malignant cells.
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