An unusual presentation of prominent crista terminalis mimicking a right atrial mass: a case report

• Main Authors: Jiang Wang, Gang Wang, Xiao Bi, Ran Zhang, Changfu Liu
• Format: Article
• Language: English
• Published: BMC 2018-11-01
• Series: BMC Cardiovascular Disorders
• Subjects: Crista terminalis; Right atrial mass; PET/MRI; Echocardiogram
• Online Access: http://link.springer.com/article/10.1186/s12872-018-0925-y

Abstract Background The crista terminalis is a variation of normal anatomical structure within the right atrium which may be misdiagnosed with an abnormal atrial mass normally visualized in the standard views on the transthoracic echocardiogram. Case presentation In this case presentation, we demonstrated a rare case report describing the accidental discovery of a right atrial mass-like structure in a 54-year old Asian man without physical discomfort during an echocardiographic examination. These findings naturally caused some concern as the differential diagnosis such as right atrial myxoma or thrombus and further examination were organized. The subsequent positron emission tomography/magnetic resonance imaging (PET/MRI) differentiated a true right atrial mass from a strip extending into the atrium in accordance with prominent crista terminalis. Conclusion A preferable understanding of the complex anatomy and PET/MRI appearance of a prominent crista terminalis will minimize the misdiagnosis of this structure and avoiding unnecessary anxiety and more invasive examinations.