Right atrial mass in a patient with breast cancer: percutaneous transcatheter biopsy under intracardiac echocardiography guidance.

Precise diagnosis of intracardiac masses is fundamental to their treatment. However, the findings of non-invasive imaging techniques are frequently inconclusive. In this setting, percutaneous transcatheter biopsy might represent a valid alternative to surgical biopsy. Intracardiac echocardiography (ICE)-guided biopsy offers high-quality imaging, is a relatively quick and easy interventional procedure to perform and does not require patient intubation or the assistance of an echocardiographer. We describe the case of a 47-year-old woman undergoing chemotherapy for breast cancer, who presented with a right atrial mass. Non-invasive imaging was inconclusive. Since no changes in the aspect or size of the mass were noticed after 2-week treatment with heparin, ICE-guided biopsy was performed, which confirmed the thrombotic nature of the mass. The patient underwent surgical resection of the thrombus and curative treatment of her breast cancer was pursued. 2016 BMJ Publishing Group Ltd.