Diagnosis
At this point, differential diagnosis included intracardiac tumor,
pericardial cyst or mediastinal mass. Contrast echocardiography revealed
free communication between the lateral echolucent structure and LA
(Figure 3C) suggesting that this was an intra-cardiac structure.
Computerized tomography (CT) chest with intravenous contrast was then
ordered for definitive diagnosis. CT chest revealed a large LAAA
measuring 6.2 cm transverse x 6.4 cm anteroposterior x 11.0 cm
cephalocaudal (Figure 4). The neck of LAA measured 3.3 cm. CT scan
showed thickening of the LAA wall and some opacities within the LAAA
cavity suggesting presence of thrombus. Aside from the LAAA, there were
no pertinent cardiac abnormalities.