Assessment of the vascularity of a left ventricular mass using myocardial contrast echocardiography.

In addition to a thrombus, an intracardiac mass lesion can represent a primary cardiac tumor, or a metastatic lesion to the heart. The echocardiographic appearance and location of the mass, as well as the associated clinical scenario provide useful clues regarding cause, but these echocardiographic features alone may not always be diagnostic. Because most benign cardiac tumors are relatively avascular, the vascularity of a mass may be a feature that can help differentiate benign from malignant tumors. We present a case of a patient with a history of malignant melanoma who was found incidentally to have a cardiac mass on echocardiography. Contrast echocardiography (CE) was used to evaluate the vascularity of the mass. This case is compared with another patient with an apical thrombus, which represents an "avascular" intracardiac structure.