Successful Mechanical Aspiration of Malignant Right Atrial Myoepithelial Tumor in Setting of Recurrent Lung Cancer

Minimally invasive endovascular procedures are increasingly used for management of intracardiac masses. Here, we present a case of successful transcatheter aspiration of a malignant right atrial (RA) mass.

A 59-year-old woman with recurrent small cell lung cancer status-post chemotherapy/radiation presented for evaluation of progressively worsening left upper extremity pain and was found to have an irregular echogenic 37 mm × 26 mm mass partially attached to the posterior atrial aspect leaflet of the tricuspid valve. The mass was successfully removed and biopsied, demonstrating malignant myoepithelial disease.

Treatment strategies generally depend on symptoms and comorbidities. Currently, most intracardiac masses undergo surgical resection; however, literature has demonstrated both mechanical aspiration thrombectomy and surgical resection to have favorable outcomes.

No evidence-based guidelines exist for optimal management of malignant RA tumors. In our patient, mechanical aspiration thrombectomy was safe and effective for removal of the intracardiac mass.