Cardiac Sarcoidosis Presenting as a Biatrial Mass With Extensive Extracardiac Involvement

The diagnosis of cardiac sarcoidosis (CS) is often challenging, particularly in atypical cases.

This case involves a previously healthy 33-year-old woman who was found to have a biatrial mass and evidence of a diffuse inflammatory or neoplastic process on multimodality imaging. Percutaneous biopsy of the cardiac mass was performed, and histopathologic examination revealed granulomas consistent with CS.

This case adds to the growing number of reports of CS manifesting as an intracardiac mass.

The clinical presentation of CS is highly variable, and it may rarely manifest as an intracardiac mass. The diagnosis of cardiac sarcoidosis is often challenging, particularly in patients with atypical presentations. Indeterminate cardiac masses often require direct tissue sampling because the changes in treatment and prognosis are substantial.