Transthoracic echo-guided transvenous biopsy of a right atrial mass

Percutaneous intravenous catheter forceps biopsy in right atrial mass: two case reports and literature review

Background

Primary malignant tumors of the heart are rare. Although preoperative histological diagnosis is difficult, it has paramount value in therapeutic strategy development and prognostic estimation. Herein, we reported 2 cases of intracardiac tumors.

Cases presentation

Both patients presented to the hospital with heart-related symptoms. Echocardiography showed massive masses in the atrium and positron emission tomography–computed tomography (PET/CT) revealed hypermetabolism and invasiveness. One patient cannot take surgery due to extensive metastasis and poor condition. The other patient was primarily diagnosed with lymphoma, and surgery was not recommended. They successfully underwent intravenous atrial biopsy, and histological samples confirmed intimal sarcoma and diffuse large B cell lymphoma. Based on immunohistochemical and molecular assessments, targeted chemotherapy was administered, resulting in clinical and imaging remission at discharge.

Conclusions

Percutaneous intravenous catheter biopsy as a safe invasive test provides an accurate pathological diagnosis after imaging evaluation, and offers a therapeutic direction. Nonmalignant masses and some chemo-radiosensitive malignant tumors in the atrium could have good prognosis after targeted therapy.

Transthoracic echocardiography-guided biopsy of a metastatic endometrial adenocarcinoma in the right atrium: a review of diagnosis and treatment of cardiac masses

We report on a 64-year-old African-American female with a past medical history of an endometrial adenocarcinoma with metastasis to the right atrium. To our knowledge, there have been only four case reports on endometrial carcinoma metastasizing to the right atrium. In our patient, a percutaneous biopsy under fluoroscopic and transthoracic echocardiographic guidance was performed. Histopathologic evaluation of the specimens revealed an adenocarcinoma, consistent with the patient's history of endometrial carcinoma. This report provides a brief review of diagnosis and treatment of cardiac masses.