E2755. Another Pic of My Heart: A Case-Based Review of Undifferentiated Cardiac Masses
Authors
Baylor Obert;
University of Mississippi Medical Center
Richard Covington;
University of Mississippi Medical Center
Aubrey Smyly;
University of Mississippi Medical Center
Elliot Varney;
University of Mississippi Medical Center
Candace Howard-Claudio;
University of Mississippi Medical Center
Background
Findings of undifferentiated cardiac masses have become increasingly prevalent with the widespread use of imaging modalities such as echocardiogram and cardiac CT for calcium scoring. Knowing the various imaging modalities used to characterize cardiac masses will improve diagnostic accuracy of incidental cardiac masses and determine its management. This exhibit will outline the various conditions considered in the differential for cardiac masses. The purpose is to produce a resource for radiologists, oncologists, cardiologists, and interested clinicians to determine the etiologies of undifferentiated cardiac masses.
Educational Goals / Teaching Points
In this exhibit, we will present a series of cases presenting with undifferentiated cardiac masses. We will discuss the role of imaging in the diagnosis of cardiac masses. Additionally, we will review radiologic features of primary cardiac tumors across multiple imaging modalities and discuss ongoing developments in their evaluation.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
There are many etiologies of cardiac masses. These are often categorized into three classes: pseudotumors, metastasis, and primary tumors. Pseudotumors are findings that mimic cardiac masses such as thrombus and pericardial cysts or normal anatomic variants often mistaken for cardiac masses including the coumadin ridge, crista terminalis, or Eustachian valve. Pseudotumors are the most common finding for undifferentiated cardiac masses. Cardiac metastases are the second most prevalent category occurring 20 - 40 times more frequently than primary cardiac tumors. Metastases reach the heart via direct, lymphatic, or hematogenous spread, often involving the pericardium or right-heart. Though primary cardiac tumors are the least prevalent class, they have a variety of presentations and are often associated with life-threatening complications, even in benign cases. Understanding the preferential locations and radiologic findings of various cardiac masses across modalities is essential to establish an accurate diagnosis and determine optimal patient management.
Conclusion
Radiologists should be knowledgeable about various pathologies, radiologic characteristics, and favored locations of cardiac masses as they are rare entities that often cause confusion. In the case of incidental cardiac masses, the radiologist will often be the first to suggest the diagnosis of cardiac mass, and knowledge of these entities can improve diagnostic accuracy and prompt correct clinical management.
