Right Ventricle Tumoral Mass in Acute Promyelocytic Leukemia (AML M3): Cardiac Magnetic Resonance Findings

Intracardiac masses found on 2D echocardiography in patients with leukemia can present diagnostic challenges. A correct differentiation between thrombi, metastases, and infective vegetations is important in the management of patients with leukemia. We describe a 24-year-old male patient, who was diagnosed with acute myelogenous leukemia (APL, AML M3). 2D transthoracic echocardiography showed 2 inhomogeneous highly mobile masses (10×13 and 6×9 mm) in the right ventricle (RV).
The masses were attached to the chordae tendineae and exhibited movements compatible with the cardiac cycle. Cardiac magnetic resonance imaging revealed 3 mobile masses in the RV attached to the RV trabeculations with isosignal intensity on steady-state free precession sequence. There was no obvious evidence of mass invasion or necrosis. On the last transesophageal echocardiography (6 months after the initial admission), the mass did not exist anymore. At the time of paper compilation, the patient has no complaints and is in remission. This report underscores the importance of cardiac magnetic resonance imaging in differentiating intracardiac thrombi aggregations of tumoral cells in APL, AML M3. (Iranian Heart Journal 2016; 17(3):46-50)