Right-sided hepatic hernia of normal left lobe resembling cardiac tumor

Area of Science:

• Cardiology
• Radiology
• Pediatric Surgery

Background:

• Transthoracic echocardiography (TTE) is a primary imaging modality for suspected cardiac masses in children.
• Right atrial masses can obstruct inferior vena cava (IVC) flow, necessitating prompt evaluation.
• Differentiating cardiac tumors from other intrathoracic pathologies is crucial for appropriate management.

Observation:

• A 3-year-old boy presented with a suspected right atrial cardiac tumor causing IVC obstruction on TTE.
• Further diagnostic workup included enhanced computed tomography (CT) and angiography.
• The initial diagnosis of a cardiac tumor was ultimately excluded.

Findings:

• The patient was diagnosed with a rare hepatic hernia containing a normal left lobe.
• The herniated liver lobe mimicked a cardiac tumor on initial echocardiography.
• Advanced imaging modalities were essential in revising the diagnosis.

Implications:

• Echocardiography findings suggestive of right atrial tumors require confirmation with advanced cross-sectional imaging.
• Enhanced CT or magnetic resonance imaging (MRI) are critical for definitive diagnosis of suspected cardiac masses.
• Awareness of rare conditions like hepatic hernia is important to avoid misdiagnosis of cardiac tumors.