Metastatic Cardiac Mass: Role of Transthoracic Echocardiography

The manifestation of cardiac masses varies considerably depending on their location. Among the primary cardiac tumors, sarcomas are the most common. Sarcomas spread mostly to lungs, but metastasis to other sites such as the liver has also been reported. Here, we report a case of a large primary cardiac sarcoma with metastasis to the liver. The patient was a 76-year-old woman who presented with dyspnea. Echocardiography revealed a thickened involved right ventricular free wall and a large multi-lobulated mass featuring multiple cavitations and necrotic foci with attachment to the right atrial free wall and extension to the atrioventricular groove. The abdominal and pelvic sonographic examination illustrated multiple heterogeneous non–well-defined masses in the liver parenchyma. The biopsy result was a cardiac sarcoma. The patient refused any therapeutic intervention.