Key result
Surgical resection of a large right ventricular mass, initially suspected to be a thrombus, revealed metastatic spindle cell adenocarcinoma, though the patient expired on the sixth postoperative day.
Why the study?
The authors aimed to increase awareness of the differential diagnosis between thrombus and tumor in a right ventricular mass to guide appropriate management.
Case Report (n=1)
This case highlights the importance of considering metastatic tumors in the differential diagnosis of right ventricular masses, even when non-invasive imaging suggests a thrombus.
RV masses initially suggestive of thrombus may represent metastatic malignancy; this case leaves open the need for refined preoperative diagnostics.
A 47-year-old woman was admitted to the hospital because of dyspnea for the past three months. She was previously diagnosed with pulmonary embolism. She had been operated on for a colon tumor five years ago and no residual cancer was detected on oncological follow-up. Her transthoracic echocardiographic and transesophageal echocardiographic evaluation showed a hypertrophic right ventricle occupied by a 2.7 x 4.8 cm immobile mass obliterated to the right ventricle cavity. All the non-invasive tests were consistent with thrombus prediagnosis. She underwent surgery. Mass was resected from the right ventricle as much as possible. Histopathology of surgical material revealed metastatic spindle cell adenocarcinoma. We aim to increase the awareness of the differential diagnosis of thrombus or tumor, thereby leading to appropriate management.
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Kandemir et al. (2023) conducted a case report in Right ventricular mass (n=1). Surgical resection was evaluated on Histopathological diagnosis and clinical outcome. Surgical resection of a large right ventricular mass, initially suspected to be a thrombus, revealed metastatic spindle cell adenocarcinoma, though the patient expired on the sixth postoperative day.
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