Intracardiac masses in a giant right atrium: Tumors or thrombus?

The coexist of primary angiosarcoma and thrombosis is a rare clinical entity. A 46-year-old male was presented with multiple right atrial (RA) masses. Two different vascular patterns in these masses were identified by contrast echocardiography. The possibility of coexistence of malignant tumors and thrombus in RA was implicated, which was further confirmed by computed tomography, magnetic resonance imaging, positron emission tomography/computer tomography, and pathologic examination. This case highlights the advantages of contrast echocardiography in the differential diagnosis of cardiac masses.