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|Number 10-01: Myofibroblastic tumor of the right atrium in a 2-year old boy|
Number 10-01: Myofibroblastic tumor of the right atrium in a 2-year old boy
Case from: Michael D Seckeler, MDa*, Christopher Clarke, MDa, James Gangemi, MDb, Robin D LeGalloc, Andrew Hoyer, MDa
Clinical history: A 2 year-old male with a history of one week febrile illness and cough was evaluated by his pediatrician and diagnosed with bronchitis and provided supportive treatment. However, the patient developed new respiratory distress.
A chest x-ray showed marked cardiomegaly and an echocardiogram revealed a large pericardial effusion (Movies1-3) with evidence of cardiac tamponade.
Movie 1 Movie 2 Movie 3
After urgent pericardiocentesis, a suspicious mass was noted in the right atrium on a repeat echocardiogram (Movie 4).
CMR tissue characterization: In the TSE T1 images the mass appeared hyperintense (Figure 1). The mass remained hyperintense also when a fat saturation pulse was added, confirming that its nature was not lipomatous (Figure 2).
The LGE images suggested that the mass had a fibrotic component (Figures 3 and 4).
Based on the CMR findings, the patient went to surgery for an open biopsy.
The patient recovered well from surgery and was discharged home.
1. Adler A, Fimbres A, Marcinak J, Johnson A, Zheng X, Hasegawa S, Shulman ST. Inflammatory pseudotumor of the heart caused by Listeria monocytogenes infection. J Infect. 2009;58:161-3.
2. Anvari MS, Soleimani A, Abbasi A, Boroumand MA, Marzban M, Karimi AA, Yazdanifard P, Shirani S, Sahebjam M. Inflammatory myofibroblastic tumor of the right ventricle causing tricuspid valve regurgitation. Tex Heart Inst J. 2009;36:164-7.