The latest issue of CASE is now available with some captivating reports, including “A Rapidly Growing Cardiac Mass—Malignant or Benign?” by Rout et al. Author Dinesh Kalra, MD, FACC, remarked, “Cardiac masses may be picked up incidentally or when evaluating a patient for symptoms and may sometimes pose a diagnostic dilemma. The first step is to determine whether a cardiac mass is a normal structure (i.e., a pseudotumor, for example, crista terminalis or lipomatous hypertrophy, or the interatrial septum) or a thrombus. The next step is to collect all the information from the patient’s history, presentation, and concomitant conditions to assess whether the mass is likely to be benign or malignant and if it can cause complications such as obstruction, thromboembolism, or clinically important arrhythmias. Herein, multimodality imaging plays a key role. In this month’s case report of a rapidly growing tumor that mimicked a malignant intracardiac tumor, we provide a multifaceted diagnostic algorithm that considers several features that help steer one to the correct diagnosis — such as the cardiac chamber where the mass originates, and multiple echocardiographic and cardiac magnetic resonance features (including tissue characterization). With this kind of a comprehensive approach, a presumptive diagnosis can be made in over 75% of cases.”
This issue features a second case in Multimodality Imaging and three in the Cardiac Tumors and Pseudotumors category, including acontrasting case to Rout et al. of a small, slow-growing LV mass that had been followed closely for years, but when the patient returned with a stroke, surgery proved this to be a fibroelastoma. Additionally, there are three insightful reports in the Echo Innovation category, including the clever use of real-time 3D echo with simultaneous multi-slice short-axis stacks as a novel approach to precisely locating the catheter tip during endomyocardial biopsy. Dr. Sorrell’s editorial invites readers to bring what they learn in these rare cases back to their echo labs, so each patient’s experience and each echo’s quality are consistently first-rate, regardless of who may be watching.
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