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Number 07-18 Right Atrial Tumour – or not?

Case from: John Petersen, Carsten Schmalfuss, Pat Mergo, Gary R. Cooper, CMR Service, University of Florida, Gainesville, FL. USA

Clinical history: An incidental mass was identified in the right atrium of a middle aged female on pre-operative trans thoracic echocardiography (top left). CMR requested for further characterization.

Cine CMR: The right atrium (4 chamber, top right) has a ‘deep’ AV groove, and prominent crista terminalis. These combine to mimic tumor. This is confirmed on tissue characterisation: the ‘mass’ is shown to be normal AV groove fat and crista terminalis (TSE and TSE with fat-sat, middle left and right).

However, the scout transaxial HASTE images (Half Fourier Single Shot Turbo (Fast) Spin Echo) show an incidental soft tissue lesion in the periphery of the right lung on transaxial imaging (arrow, bottom image).

Perspective: The apparent mass on echocardiography can be dismissed, but CMR reveals a previously unsuspected non cardiac abnormality. Attention should be paid on reporting CMR to the non-cardiac anatomy.

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