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Tumours and masses 

Tumours and masses
Tumours and masses

M.J. Andrade

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date: 14 August 2020

Transthoracic and transoesophageal echocardiography is the first-line diagnostic tool for imaging space-occupying lesions of the heart. Cardiac masses can be classified as tumours, thrombi, vegetations, iatrogenic material, or normal variants. Occasionally, extracardiac masses may compress the heart and create a mass effect. Cardiac masses may be suspected from the clinical presentation. This is the case in patients with an embolic event presumed of cardiac origin or in patients with infective endocarditis. Otherwise, a cardiac mass can be identified during the routine investigation of common, non-specific cardiac manifestations or as an incidental finding.

In general, an integrated approach which correlates the patient’s clinical picture with the echocardiographic findings may reasonably predict the specific nature of encountered cardiac masses and, in the case of tumours, discriminate between primary versus secondary, and benign versus malignant. Furthermore, echocardiography alone or with complementary imaging modalities, can provide information to help decide on the resectability of cardiac tumours, enhance effective diagnosis and management of infective endocarditis, and assist in planning therapy and follow-up. Because several normal structures and variants may mimic pathological lesions, a thorough knowledge of potential sources of misinterpretation is crucial for a correct diagnosis. After surgical resection, histological investigation is mandatory to confirm the diagnosis.

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