Clinical introduction
A woman in her 50s with bilateral lower extremities pitting oedema and dyspnoea for 3 months was admitted to hospital. Transthoracic echocardiography revealed a 7.2 cm×5.6 cm, hypoechoic mass in the left atrium. Colour Doppler flow imaging demonstrated no blood flow signals within the mass (figure 1A,B). Cardiac CT scan demonstrated a soft tissue density lobulated mass in the left atrium with heterogeneous slight enhancement (figure 1C,D). Non-visualisation of the left pulmonary vein was observed. To further evaluate the lesion, the patient underwent contrast-enhanced cardiac magnetic resonance. The mass showed broad-based low T1-weighted signal (figure 1F), inhomogeneous slightly lower T2-weighted signal (figure 1G), inhomogeneous gadolinium enhancement (figure 1H) and inhomogeneous late gadolinium enhancement (figure 1I), which clearly delineated the central non-enhancement area and tumour invasion into the left superior and inferior pulmonary veins. Magnetic resonance cine sequences are provided as online supplemental videos 1 and 2. Due to tumour involvement of the left superior and inferior pulmonary veins, …
