case_images: PMC10791096_01
case_images: Modified short-axis view at the base of the heart from the left parasternal window showing the right atrial mass (blue arrow); but the origin or the attachment of the mass could not be visualized from this view. The lower (juxta-atrial) superior vena cava could not be visualized from this view.
case_images: cureus-0016-00000052352-i01.jpg
case_images: PMC10791096_01_cureus-0016-00000052352-i01.jpg
case_images: FIG1
case_images: Because of the presence of dyspnea and neck vein distention, 2D transthoracic echocardiography was performed; a mass was noted inside the right atrium from the left parasternal and apical windows, but its attachment or origin could not be visualized (Figures 1-3); the lower (juxta-atrial) SVC could not be visualized from these windows.
case_images: Apical four-chamber view showing the right atrial mass (blue arrow); the origin or the attachment of the mass could not be visualized from this view. The lower (juxta-atrial) superior vena cava could not be visualized from this view.
case_images: cureus-0016-00000052352-i02.jpg
case_images: PMC10791096_01_cureus-0016-00000052352-i02.jpg
case_images: FIG2
case_images: Because of the presence of dyspnea and neck vein distention, 2D transthoracic echocardiography was performed; a mass was noted inside the right atrium from the left parasternal and apical windows, but its attachment or origin could not be visualized (Figures 1-3); the lower (juxta-atrial) SVC could not be visualized from these windows.
case_images: Apical five-chamber view showing the right atrial mass (blue arrow); the origin or the attachment of the mass could not be visualized from this view. The lower (juxta-atrial) superior vena cava could not be visualized from this view.
case_images: cureus-0016-00000052352-i03.jpg
case_images: PMC10791096_01_cureus-0016-00000052352-i03.jpg
case_images: FIG3
case_images: Because of the presence of dyspnea and neck vein distention, 2D transthoracic echocardiography was performed; a mass was noted inside the right atrium from the left parasternal and apical windows, but its attachment or origin could not be visualized (Figures 1-3); the lower (juxta-atrial) SVC could not be visualized from these windows.
case_images: Modified subcostal view of the right atrium showing actually that the right atrial mass originated from the lower (juxta-atrial) superior vena cava and is prolapsing into the right atrium. Blue arrow showing the right atrial mass originating from the lower (juxta-atrial) SVC. Red arrow showing the ascending aorta. Yellow arrow showing the liver.
case_images: cureus-0016-00000052352-i04.jpg
case_images: PMC10791096_01_cureus-0016-00000052352-i04.jpg
case_images: FIG4
case_images: The subcostal window (modified subcostal view of the right atrium) allowed visualization of the lower (juxta-atrial) SVC and the mass was seen originating from the distal part of the SVC and prolapsing into the right atrium (Figures 4, 5).
case_images: Same modified subcostal view of the right atrium with color coding showing no aliasing of color flow around the right atrial mass originating from the lower (juxta-atrial) superior vena cava, indicating no major obstruction to flow. Blue arrow showing the right atrial mass originating from the lower (juxta-atrial) SVC. Red arrow showing the ascending aorta. Yellow arrow showing the liver.
case_images: cureus-0016-00000052352-i05.jpg
case_images: PMC10791096_01_cureus-0016-00000052352-i05.jpg
case_images: FIG5
case_images: The subcostal window (modified subcostal view of the right atrium) allowed visualization of the lower (juxta-atrial) SVC and the mass was seen originating from the distal part of the SVC and prolapsing into the right atrium (Figures 4, 5).
case_images: CT scout view of the chest showing an enlargement of the mediastinum (blue arrows).
case_images: cureus-0016-00000052352-i06.jpg
case_images: PMC10791096_01_cureus-0016-00000052352-i06.jpg
case_images: FIG6
case_images: CT scout view of the chest showed an enlargement of the mediastinum (Figure 6).
case_images: Enhanced CT scan of the chest showing a large anterior mediastinal mass (blue arrow).
case_images: cureus-0016-00000052352-i07.jpg
case_images: PMC10791096_01_cureus-0016-00000052352-i07.jpg
case_images: FIG7
case_images: CT scan of the chest was performed which showed a large anterior mediastinal mass invading the SVC and prolapsing into the right atrium (Figures 7, 8). CT scan of the chest also showed metastasis to the right upper lung field (Figure 9).
case_images: Enhanced CT scan of the chest showing the anterior mediastinal mass invading the superior vena cava and prolapsing into the right atrium (blue arrow).
case_images: cureus-0016-00000052352-i08.jpg
case_images: PMC10791096_01_cureus-0016-00000052352-i08.jpg
case_images: FIG8
case_images: CT scan of the chest was performed which showed a large anterior mediastinal mass invading the SVC and prolapsing into the right atrium (Figures 7, 8). CT scan of the chest also showed metastasis to the right upper lung field (Figure 9).
case_images: Enhanced CT scan of the chest showing a large metastasis to the right upper lobe (blue arrow).
case_images: cureus-0016-00000052352-i09.jpg
case_images: PMC10791096_01_cureus-0016-00000052352-i09.jpg
case_images: FIG9
case_images: CT scan of the chest was performed which showed a large anterior mediastinal mass invading the SVC and prolapsing into the right atrium (Figures 7, 8). CT scan of the chest also showed metastasis to the right upper lung field (Figure 9).
case_images: Core needle biopsy being done under CT guidance (blue arrow).
case_images: cureus-0016-00000052352-i10.jpg
case_images: PMC10791096_01_cureus-0016-00000052352-i10.jpg
case_images: FIG10
case_images: Needle being advanced into the tumor under CT guidance to perform the core biopsy (blue arrow).
case_images: cureus-0016-00000052352-i11.jpg
case_images: PMC10791096_01_cureus-0016-00000052352-i11.jpg
case_images: FIG11
case_images: Pathology specimen showing thymoma type B2.
case_images: cureus-0016-00000052352-i12.jpg
case_images: PMC10791096_01_cureus-0016-00000052352-i12.jpg
case_images: FIG12
case_images: Pathology showed thymoma type B2 (Figures 12, 13).
case_images: Pathology specimen showing thymoma type B2.
case_images: cureus-0016-00000052352-i13.jpg
case_images: PMC10791096_01_cureus-0016-00000052352-i13.jpg
case_images: FIG13
case_images: Pathology showed thymoma type B2 (Figures 12, 13).