Large aortic aneurysm mimicking a cardiac tumor.
BACKGROUND
Extrinsic left atrial compression caused by a displaced, crooked descending thoracic aorta is rare. This anomaly may mimic primary cardiac tumors or metastatic neoplasms from the first look.


METHODS
We reported a 78-year-old woman presented to our emergency room with back pain, increased exercise intolerance and intermittent angina. She also had one syncopal event 1 month ago and gastric cancer post gastrectomy history. Subsequent chest plain film showed no mediastinum widening.Two-dimensional echocardiography was performed and revealed a heterogeneous mass as large as 2.3 x 2.4 cm occupying the left atrium (LA). Three-dimensional echocardiography vividly demonstrated that LA was constrained between the aortic valve (AV) and a luminal structure with pulsatile character suggestive of the aorta.


CONCLUSIONS
We successfully demonstrated the detailed structure and location of an anomalous descending aorta on the oblique imaging plane of RT-3DE, which may not be readily available by traditional 2D method.
Liao
Zhen-Yu
ZY
Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
Tsai
Jui-Peng
JP
Kuo
Jen-Yuan
JY
Hung
Chung-Lieh
CL
D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006338:Heart Neoplasms / Q000175:diagnosis*; D006801:Humans; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed