Background: Intracardiac masses in the setting of a congenital heart disease poses a challenging yet interesting diagnostic problem. Diagnostic dilemmas in this setting can occur making it difficult to truly define the disease entity.
Case: This is a case of a 44 year old female, diagnosed with Ebstein Anomaly, Immune Thrombocytopenia and Papillary Thyroid Cancer who developed progressive right sided heart failure and was found to have a right atrial mass that progressively enlarged to occupy almost the entirety of the right atrium. A primary neoplasm, metastasis from the thyroid cancer and a thrombus were considered but diagnostic dilemmas proved difficult to overcome.
Conclusion: A mass on cardiac imaging may represent a great variety of diseases. In an unusual case as presented above, there is not one single imaging test that could truly define the right atrial mass. When faced with a complex case involving an unidentifiable mass lesion, a biopsy should always be sought to allow early initiation of definitive management