title: A right atrial mass, patent foramen ovale, and indwelling central venous catheter in a patient with a malignancy: a diagnostic and therapeutic dilemma.
abstract: A 33-year-old woman with a history of gestational trophoblastic disease presented for investigation of a right atrial mass. She had been receiving chemotherapy administered via a Port-a-Cath system for 2 months prior to presentation. On transesophageal echocardiography and magnetic resonance imaging, she was found to have a mass attached to the right atrial free wall, with a segment projecting across a patent foramen ovale. Because of the risk for an embolic event, the mass was surgically removed and the patent foramen ovale repaired. Pathology showed an organized thrombus. This case emphasizes the need for high suspicion for thrombus when a right atrial mass is found in a patient with a hypercoagulable state due to underlying malignancy who has a central venous catheter.
authors.affiliation: Division of Cardiology, Department of Medicine, Emory University Hospital, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Funt
authors.forename: Stamatios
authors.initials: S
authors.lastname: Lerakis
authors.forename: Dalton S
authors.initials: DS
authors.lastname: McLean
authors.forename: Patrick
authors.initials: P
authors.lastname: Willis
authors.forename: Wendy
authors.initials: W
authors.lastname: Book
authors.forename: Randolph P
authors.initials: RP
authors.lastname: Martin
mesh_terms: D000328:Adult; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000601:surgery*; D031901:Gestational Trophoblastic Disease / Q000150:complications*; D006325:Heart Atria; D006801:Humans; D011247:Pregnancy; D013927:Thrombosis / Q000175:diagnosis* / Q000601:surgery*