Cardiac Tumor: An Incidental Finding
A 41-year-old man with no past medical history presented to the emergency department with 3 weeks of progressive headache. Additionally, he noted fatigue, dizziness, exertional dyspnea, and a 20-pound weight loss over the prior 6 months. Initial blood pressure was 206/140, and a heart murmur was heard over the left sternal border. A urine drug screen was positive for cocaine. A transthoracic echocardiogram showed a large right atrial mass, and subsequent transesophageal echocardiogram showed a heterogeneous mass measuring 5.6 x 4.6 cm that appeared to be attached to the right atrial appendage, lateral tricuspid valve annulus, and possibly right ventricle. The tricuspid valve was obscured by the mass, but an increased pressure gradient was noted with severe functional stenosis. Cardiac magnetic resonance imaging (CMRI) was concerning for angiosarcoma versus lymphoma (Figure 1).
Which of the following is true regarding the diagnosis and management of suspected cardiac tumors?