What is the clinical evidence from this study?

Study design: Case Report. Population: Intracardiac mass (n=1). Intervention: Multimodality imaging (TEE and CMR). Primary outcome: Definitive diagnosis.

What does this research mean for the field?

Interval growth of an intracardiac mass despite anticoagulation therapy should prompt diagnostic reassessment and advanced cardiac imaging to evaluate for malignancy. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To describe the clinical presentation and diagnostic evaluation of an intracavitary cardiac mass that mimicked a thrombus but was confirmed as metastatic malignancy.

September 10, 2026European Heart Journal - Case ReportsOpen Access

An Intracavitary Right Ventricular Mass: A Diagnostic Dilemma - A Case Report

Q: What are the key findings of this study?

Advanced multimodality imaging and biopsy of an enlarging right ventricular mass despite anticoagulation revealed metastatic non-small cell lung carcinoma.

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Key result

Multimodality imaging and biopsy identify metastatic lung carcinoma in an anticoagulation-refractory RV mass.

Why the study?

Intracardiac masses present a diagnostic challenge because thrombus and malignancy can exhibit similar initial imaging features.

Design

Case report

Authors

JHJiries HaddadProvidence Hospital DGDhruva GovilHenry Ford Health System SRSushmithaa RameshProvidence Hospital

Discussion

Member takes

Implication

Non-regressing intracardiac masses merit malignancy evaluation; supports multimodal imaging reports but remains hypothesis-generating.

Key Points

To describe the clinical presentation and diagnostic evaluation of an intracavitary cardiac mass that mimicked a thrombus but was confirmed as metastatic malignancy.
Clinical and diagnostic workup of a 79-year-old male with an incidental right ventricular outflow tract mass initially treated with apixaban anticoagulation for presumed thrombus.
Multimodality imaging including transthoracic echocardiography, transesophageal echocardiography, and cardiac magnetic resonance imaging followed by histopathologic evaluation.
Follow-up transthoracic echocardiography demonstrated interval enlargement of the right ventricular mass from 2.4 × 1.7 cm to ~2.4 × 2.9 cm despite systemic anticoagulation.
Cardiac magnetic resonance imaging demonstrated early contrast enhancement indicating neovascularization, and biopsy confirmed poorly differentiated non–small cell lung carcinoma with PD-L1 expression <50%.
Because of advanced stage IV disease, poor functional status, and weight loss exceeding 10%, disease-directed therapy was deferred in favor of transition to hospice care.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 79-year-old male with an incidentally discovered right ventricular outflow tract mass initially presumed to be a thrombus.

Intervention

Anticoagulation (apixaban) followed by multimodality imaging (TTE, TEE, CMR) and biopsy.

Outcome

Diagnosis of the intracardiac mass

Interval growth of an intracardiac mass despite anticoagulation should prompt diagnostic reassessment and advanced cardiac imaging like CMR to rule out malignancy.

Cite This Study

Haddad et al. (2026) conducted a case report in Intracardiac mass (n=1). Multimodality imaging (TEE and CMR) was evaluated on Definitive diagnosis. Advanced multimodality imaging and biopsy of an enlarging right ventricular mass despite anticoagulation revealed metastatic non-small cell lung carcinoma.

synapsesocial.com/papers/6aa269eaa1e750260650a002 https://doi.org/10.1093/ehjcr/ytag676

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An Intracavitary Right Ventricular Mass: A Diagnostic Dilemma - A Case Report

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

An Intracavitary Right Ventricular Mass: A Diagnostic Dilemma - A Case Report

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

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